Could GPs request tests to rule out other conditions that are contributing to what could be PMR before starting on prednisone?

[Sunny465]

I was diagnosed 2 years ago by a GP. Said to have PMR. No testing for what it might be otherwise. Mainly a complaint in my lower back and legs, pelvic girdle joints and so on. Muscle cramps and middle toes going numb and sciatic nerves big time. He asked if I had pain other typical areas as happens with PMR. I said not really too bad -soreness bewteen the shoulder blades. And my neck cops it from time to time. He ticked the box anyway. He said I have a disease and that I must have prednisone to put the fire out. CPR level was at 38. He stated what I can expect of this diagnosis and the correlation with osteoporosis and cardiovascular disease as per statistics. I didn't think it was helpful re PMR at that moment. It stopped me in my tracks as the lower back was more than I could put up with at the time.

That was Nov. 2016 . So the focus shifted from what I came in about leaving me with to 2 years to life on Prednisone. I reduced down to an ineffective amount to find a functional level but stayed with it to see if would settle at 7mgs as the Doc instructed.

No good. Changed doctors. No Rheumy in town to advise. The new GPs didn't treat me as a new patient. Just went with the box ticked. No idea on tapering and pacing. It is agony as you well know., I discovered the dead slow method for reducing on line. And the pred. at breakfast wasn't working so took it back to 2am. The GPs didn't support this but they didn't offer any options. They just wanted me to reduce down. As though i was drug dependent. PHEW. IT WAS EPIC. 3 and a half months of uncertainty at the lower dose and then finally as you would advise take it up a couple of notches and voila! ... pain relief.

Until i lifted something and the periformis thing kicked in in concert with the nerves down the legs etc. I suppose this all sounds familiar in many ways, a variation on a theme for some of us.

The news I have to share is that I came off the Pred in October 2017. Two weeks following the upper arms hands and neck have been giving me heaps. I was overseas so I put myself on hold.

I had a postrural assessment done before Christmas. Went for results and it looks like ostoearthritis for me. The the spine is wonky here and there and the neck affected. It seems the pelvis is slightly out along with curvatures and the orig. one where the sacrum meets the lower spine. A little deterioration between two vertebrae. Just sayin.... PMR MAYBE? .....but it wasn't the WHOLE story. I got distracted and scared with the limited perspective I was told to accept. As if I had been chosen to be unwell. Or it chose me. Then all the garbage re stigma regards the mysterious Polymyalgia and Fibromyalgia for that matter. Either way isn't it crazy?

On my original visit I asked for an xray of my lower spine. The GP did not agree. He gave in on the 3rd visit. No mention of a curvature. The complete report came up on the screen when I transfered. You know how it goes...at the very least I do know what is contributing what has been developing for a long time. SORTED! love from me folks.

[Sunny465]

oops sorry that was: I came off the Pred. Oct.2018.

[PMRpro Ambassador]

Sounds very similar to me - I have PMR plus myofascial pain syndrome which causes similar back problems to what you describe. At one point I was told, without x-ray, that I have OA in the lower spine, that was what was stopping me standing or walking for more than 10-15 minutes without pain and I would have to get used to it. After a year or so of pain after a whiplash injury, my entire back went into spasm and I couldn't move without excuciating pain. At A&E they admitted me and gave infusions of steroids, painkillers and diazepam as a muscle relaxant. It worked well - until after the second diazepam infusion when I reacted with a major atrial fibrillation episode, it is a known if rare adverse effect.

I was handed over to the pain clinic - where the specialist was horrified at the state of my back muscles, hard as boards. That was the source of ALL that pain, she worked on it for a few months and for 5 years I have managed it with remedial massage at intervals and been able to reduce the pred dose relatively low - higher doses help the MPS too. At present I have a flare, of the PMR as well as the MPS - and am waiting patiently for the referral appointment. But I don't now have problems getting imaging to prove that, no, it isn't that "wear and tear" you want to put everything down to...

[SheffieldJane]

Your concentration has been necessary and astounding. It is a familiar story. Well done for collating it and gaining insight. We are going to have to continue being our own best friend and intelligent, questioning patients. In spite of Pred head that tries to undo me.

[bunnymom]

My Ortho Dr said to me while discussing a bulging neck disc and PMR, you have quite a bit to sort out and it's difficult isn't it? No lie.

[Dream21]

Before my GP diagnosed PMR, I had many other tests first. It is a diagnosis made after other possible causes are ruled out. We know our body best. If you feel uneasy, see your doctor. Be your best advocate. Other concerns can arise as we age. Addressing our concerns with our doctor, helps to relieve our anxiety about our health. That can be a huge relief.

[Ranchero]

Another case of the doctor failing to LISTEN to the patient. The information any medic requires is sitting there in front of them - if only they would forget their own agenda and just listen. Hope all goes well for you.