PMR and muscle response

[PMRpixie]

I'd appreciate anyone's opinion re PMR and muscle response. My Rheumatologist says that the inflammation in the muscle from PMR can damage the muscle which I felt was one justification for taking Pred. She says the restricted blood flow from the swollen vessels doesn't allow nutrition/02 to nourish the muscle tissue. She does muscle biopsies so the explanation seemed reasonable. Another blog totally disagreed with me stating PMR causes NO muscle damage. I'd really like another opinion. Anyone? I have always found this forum to have more PMR wisdom than any other! Thanks.

[SheffieldJane]

If I remember what PMRPro said correctly, it is the former.

[HeronNS]

I quite like this article. Like any description of PMR there is always something to quibble about but this is a nice clear description of what is going on, as far as we know, with PMR.

health.harvard.edu/diseases...

[nickm001 in reply to HeronNS]

article needs subscription....

[PMRpixie in reply to nickm001]

Wish there was a way to read this with out buying a subscription ??

[HeronNS in reply to nickm001]

Well I checked and today it asks for a subscription. I found the article through a google search yesterday and was able to delete a pop-up and carry on reading.

[HeronNS in reply to HeronNS]

This article is not worth a subscription. The relevant paragraph was describing the effect of PMR on muscles and the synovium (joints) but also saying PMR does not damage joints. Unfortunately I don't have access any more either! I should have copied and pasted the pertinent information.

[HeronNS in reply to nickm001]

Aha - ignore my link and google: does PMR damage muscles . At least as I write this a readable version appears.

[nickm001 in reply to HeronNS]

got it! thanks !

[nickm001]

I think it is better to say that PMR and inflammation in blood vessels CAN cause muscle damage. One should think how to compensate for that condition and the answer is gentle physical activity, or moderate exercise which would increase blood supply to muscles and counter the effect of PMR. Besides lack of nutrition, one side effect of steroids is that it changes metabolic process in the cells and inhibits protein rebuilding process that is essential for muscle health. Exercise (moderate intensity) also helps to improve muscle recovery.

[Mks9558]

I have Steroid Induced Myopathy- caused by prednisone not PMR. I would suggest it is the steroids that can damage the muscles not PMR.

[PMRpro Ambassador in reply to Mks9558]

Both cases apply - I had PMR for 5 years without pred and it was very hard work doing anything and inactivity causes muscle wasting too. I have been fine for years on prednisone and also prednisolone in the past - but within a few months of starting methyl prednisolone in between I suffered severe muscle problems and other side effects while not getting decent relief of the PMR even at 20mg. I was switched to Lodotra (delayed release prednisone) and got full relief at 15mg immediately and was able to taper to below 10mg quite quickly. PMR does the long term damage because of the inabilty to exercise. I've experienced both.

[Rimmy]

I have had some myopathy - fortunately not serious and has reduced with tapering down - but I did have an injury to my Achilles tendon a while ago which took a wee while to heal. i did some research around muscles and Pred at the time and unfortunately it appears corticosteroids can alter the 'microarchitecture' of muscles. Thing is it's a fine line depending not only on current dose but also cumulative dose, how much exercise you are getting - yes and that means not 'too little' or 'too much' - and I know that's a fine line. I basically agree with nickm001 - this is about usually getting some 'moderate' exercise - but if you have damage to start with do build up very carefully again.

Best wishes

Rimmy

[Telian]

I've always been led to believe it affects the muscles.

[PMRpixie in reply to Telian]

Me too.

[Sandradsn]

I asked my physiotherapist when I was having physio for hip bursitis about pred causing muscle damage.He said if I was on it for 20 years maybe! I wasn't convinced 🤔

[PMRpro Ambassador]

Both cases apply - I had PMR for 5 years without pred and it was very hard work doing anything and inactivity causes muscle wasting too. I have been fine for years on prednisone and also prednisolone in the past - but within a few months of starting methyl prednisolone in between I suffered severe muscle problems and other side effects while not getting decent relief of the PMR even at 20mg. I was switched to Lodotra (delayed release prednisone) and got full relief at 15mg immediately and was able to taper to below 10mg quite quickly. PMR does the long term damage because of the inabilty to exercise. I've experienced both.

[Trish21 in reply to PMRpro]

I have very weak legs almost like they are going to give way especially around the knees. Is this pmr symptoms or steroids reaction? Also quite bad vertigo. Very new to all this

[PMRpro Ambassador in reply to Trish21]

Impossible to say - could be either. The vertigo isn't typical of PMR - but could be a symptom of GCA so I would speak to your doctor about it. I think lots of people have wobbly legs though! Ask the question in a new thread so more people see it and see what others say.

[PMRpixie in reply to PMRpro]

Thanks so much for your reply. It just seems plausible that blood supply to muscles could be diminished from PMR's inflammation and could therefore rob muscle tissue of nutrition. I think there's a lot about PMR that we don't know. I always love the statement on the handouts - "May cause mild morning stiffness".

Haha

[PMRpro Ambassador in reply to PMRpixie]

Exactly and quite!!!!!!!!!!!!!

[Valnvaughan]

I’ve had PMR nearly 4 years and have been taking Prednisolone, max dose 15 mg per day and now at 4 mg. I developed severe osteoarthritis 16 months ago and had hip replacements in May and October 2018. My physio told me my muscles are extremely weak after such restricted mobility and sets me increasingly taxing exercises along with the request to walk a little further each day. It is a slow process, but she says there is no reason why my mobility should not be comparable to anyone else my age when PMR burns itself out. Valerie

[Noosat]

My experience is that before PMR I had strong muscles in my legs, a competitive runner in my middle years, however forced inactivity, or really less activity, has weakened those muscles. Perhaps Prednisone also plays a part. In addition the weather this season has been such that seldom could I go to the park with Lily, dog. This coming week, I intend to enroll in a gym that has a very good class 3 days a week for muscle strengthening and flexibility, It also has a terrific room with all the equipment one could imagine. (named the "cardiac" room)

[daworm]

I would think that not being very active because of the pain and stiffness of PMR results in muscle wasting, don’t use it..lose it...I suppose that’s a side effect of PMR but I doubt PMR attacks the muscles..could be wrong though, I was once in 72...

[daworm]

This is from a Harvard study, seems right to me...””On its own, PMR does not produce muscle weakness or restricted joint motion. But if untreated, pain and stiffness limit a patient's activity to the extent that muscles become wasted and weak, and joints become stiff from simple disuse.””

[daworm]

health.harvard.edu/diseases...

[HeronNS in reply to daworm]

That's the article which you can't read without a subscription, although it seems you can access it through googling: does PMR damage muscles .

[daworm]

Hmmm. I see now...one way it comes through...so...that link ain’t no good folks! 🤪🤪

[PMRpixie in reply to daworm]

Lol

[OutdoorsyGal]

5 months post-prednisone, I am finding that my legs are still pretty strong, but my arm muscles have wasted considerably during my PMR/prednisone. I kept skiing and hiking throughout my illness and treatment and attribute my leg strength to that.

It is much harder to exercise arms through normal activities, I guess, and I’m not one for organized exercise, so now I’m paying for my lack of diligence. Most days I have to split a stack of plates before lifting them into the cupboard.

[PMRpro Ambassador in reply to OutdoorsyGal]

Get a couple of 500ml water bottles and put some water in them - how much depends on how good your arms are already but too little is better than too much. Do some reps every time you think about it - and as your arms improve, add some water. Maybe even get to bigger bottles!

[OutdoorsyGal in reply to PMRpro]

I do have some light weights (1#, 2#) and stretch bands from when I was rehabbing a shoulder injury (way pre-PMR). If only I can remember where they are!

Soup cans also work.

[PMRpro Ambassador in reply to OutdoorsyGal]

Yes - but soup cans aren't so easily adjustable ...

[OutdoorsyGal in reply to PMRpro]

Condensed vs “chunky”! 😆