Beginnings of PMR or rotator cuff?

[Judy211]

I’m GCA since March 2017 and I’ve fared pretty well considering...no fatigue so I’ve kept up the exercising without overdoing i too much. Im now down at 3mg having held for 5 months at 5mg and I’ve reduced using dead slow to get to this dose. Anyway, since Christmas, I have started to have problems with my right rotator cuff, can’t sleep on that side at night etc and just a bit of a dull ache a lot of the time. This last week I decided to sand down my big kitchen table ready for re oiling. Now I’ve got even worse problems with my left cuff!

I’m just wondering whether my ligaments and rotator cuffs have been damaged by Pred over the past two years or whether I am experiencing the first symptoms of PMR? I had a blood test 3 weeks ago which was normal...I’ll get it re done this week and see whether things have changed. Has anyone had the same? Does it sound like PMR? I’d be really grateful to hear your feedback.

[SnazzyD]

Hello, the trouble with Pred is it weakens muscles and ligaments. Strains are very easy and I’ve found my shoulders very prone to over use, especially if from repetitive work. It’s getting better with time but a lot slower than I thought. A GP should be able to do a an exam to decide if it’s a cuff problem and then hopefully get some physio going. I know others have had different problems with their shoulders and will probably reply.

[Judy211 in reply to SnazzyD]

Thanks for replying Snazzy. Sounds like you think it’s cuff problems... which I can deal with. Just had a horrible thought this last week it might be PMR rearing it’s ugly head!

[SnazzyD in reply to Judy211]

Nothing beats a proper exam by someone who has got eyes on you. I’m saying it could well be rotator cuff but I can’t say for sure. Even if it is, it is still worth not just heaving a sigh of relief it’s not PMR and leaving it. A chronic non PMR problem can be just as debilitating.

[Yellowbluebell]

I have had a rotator cuff tear in my right shoulder 3 times along with other issues and had 8 operations on it before a complete replacement 2 years ago. The pain i get from my shoulder issues is different to the pain i get from pmr. There is a very obvious difference for me. Do you know you have an issue with your rotator cuffs? Also if it has been confirmed are they full or partial tears? Have you had an mri as that's when my tears showed twice and on one occasion it was only discovered when the surgeon started operating. Do not assume it's pmr or rotator cuff tear as there are many other reasons for your shoulder to hurt and you need to find out exactly it is you are dealing with x

[Judy211 in reply to Yellowbluebell]

Hi. Poor you, you’ve obviously had your share of shoulder problems. I haven’t seen a specialist yet or had an mri so I don't know exactly what Im dealing with but there is definitely an issue with both rotator cuffs. I am also getting aches across the top of my shoulders and neck which is why Im wondering whether emerging PMR could just possibly be an issue too...hopefully not! I’ll get on to it this week and try get a gp appoint. with a view to being referred on. As you’ll know really well, it is debilitating...and like all these ailments, so frustrating!

[Yellowbluebell in reply to Judy211]

You really need to get an mri to get a definite diagnosis because there are so many little things in the shoulder that causes the pain. Mine didn't start with a cuff tear but I had arthritis in the joint when I was 29 apparently. Prob due to too much sport. One thing I will warn you about is a lot of specialists use steroid injection.s as an early treatment/diagnostic tool so if you are taking pred your pain will prob disappear irrelevant of the cause. An mri will hopefully clear up exactly what is wrong. Good luck

[Judy211 in reply to Yellowbluebell]

Thank you. I think an mri is the best plan... I’ll get onto it tomorrow and hopefully get the ball rolling.

[PMRpro Ambassador]

PMR all too often starts with a shoulder problem that is then mis-diagnosed as frozen shoulder or the like. The only real way to know is to have an MRI done to look for mechanical damage. For you it is possible it could be either because as you say, pred isn't good for ligaments/tendons. But I've been on pred for 9+ years and I don't really have any soft-tissue probems so it isn't a definite thing. As YBB says - don't make assumptions and don't allow doctors to make assumptions.

[Judy211 in reply to PMRpro]

You’re right, it could be either at this stage. I’ve been tossing up whether to up my Pred dose but I think the best course is a trip to the doctor and get it properly checked out. That’s Monday mornings battle!

[PMRpro Ambassador in reply to Judy211]

Out of interest - does a bit more pred reduce it? I'd doubt it would stop mechanical pain but it would improve PMR pain -and give you something on which to orientate.

[Judy211 in reply to PMRpro]

I haven’t tried...been a bit reluctant to but it could be worth just upping to say 5 mg for a few days? Or would you go a bit higher?

[PMRpro Ambassador in reply to Judy211]

I'd try the 5mg first - that is what many good rheumies recommend for a flare due to overshooting the mark. You can take it for up to a week or 10 days and still drop straight back to the old dose (or, preferably, old dose plus 1).

[Yellowbluebell in reply to PMRpro]

From what I know about mechanical pain like mine, pred doesn't get rid of it. I take tramadol for the non pmr pain. I have tried upping the pred for a few days to see if it effected it and it didn't for me.

[PMRpro Ambassador in reply to Yellowbluebell]

Exactly - which was why I suggested it. If it helps, the pain is possibly more likely to be PMR. If it doesn't - more likely to be mechanical.