Can a PMR relapse resolve without Prednisone?

[OutdoorsyGal]

I was off prednisone for less than 2 months when pains and stiffness began to return, though including other body parts (wrists, elbows) than the initial PMR. I was ready to go back on Prednisone, but unable to act on it because of a planned ski trip.

During the trip, the symptoms have lessened, however. I was doing isometric exercises in the hot tub after skiing each day, and that seemed to help.

So my question is, IF I was indeed having a PMR relapse, can it resolve itself?

Is there any harm in taking a “wait and see” approach, or do I “need” prednisone to prevent further damage?

Thanks in advance.

[OutdoorsyGal]

(Sorry about the typos. Can’t find an edit feature on here.)

[SnazzyD in reply to OutdoorsyGal]

You hit the More option below the post.

[OutdoorsyGal in reply to SnazzyD]

Thanks!

[SnazzyD]

My personal view is that inflammation can wax and wane but there can come a point where it goes into free fall and your abilities to combat it are overwhelmed. My personal plan for the future if I ever get off Pred is if I get a whiff of inflammation gathering momentum I’ll have a puff of Pred to try to head it off at the pass rather than avoid it.

[PMRpro Ambassador]

I had PMR for 5 years without pred. I did aquafit to keep mobile - didn't greatly help pain but did allow me to move better - and time in the steam room was key. I had a flare shortly after returning from a ski trip when I had managed to ski reasonably well but not the length of day I usually did. I was stopped from driving for another reason - incorrect as it turned out - but it left me housebound and bored out of my skull. I managed to get here to the flat, got my ski gear to the storage facility at the bottom of the mountain which meant I could (just) walk to the village in ordinary shoes to the ski bus. After a single very short run I could move better and would ski for an hour or so before coming home - time governed by buses! I could walk home almost properly and the pain was far less. Not gone but less. The hip movement of skiing is obviously ideal for mobilising PMR-ravaged hips!

PMR often varies day to day anyway. I think it cycles over time, a sinus curve, but with the peak activity always tending to reduce over time. If you find the right exercise for you, the symptoms can be improved a lot. I survived 5 years of unmanaged pred - has that any bearing on how long it has lasted? The difficulty I have reducing and getting to a low dose?

As to damage - who knows? Unmanaged, even low grade, inflammation can cause tissue damage, in the long term predispose to certain cancers developing, vascular damage can be caused which will potentially lead to peripheral vascular disease.

[Polywotsit PMRGCAuk team member]

Hi there. For the first year or so after I stopped taking pred, I would have what I called 'PMR days', when I would wake up stiff and in pain, feeling wiped out, etc. I tried to scale down activity on those days and medicated myself with paracetemol and ibuprofen. By lunchtime I was usually feeling a fair bit better. I found that these days became more and more spaced out until eventually I was only getting them if I was coming down with something.

[bunnymom in reply to Polywotsit]

That is very reassuring to know. I'm filing that away for when I reach club zero.

[OutdoorsyGal]

Thanks, KateGilbert. How long were you “on” prednisone? And how long have you been off of it?

[Polywotsit PMRGCAuk team member in reply to OutdoorsyGal]

Hi - I was on for four and a half years, most of that time under 10mg. And I have been off it for 8 years.

[OutdoorsyGal in reply to Polywotsit]

Good for you!

[mrsQuics]

I'd say try homeopathy ... Under a good practitioner as they get the amounts right/ know when to switch remedies ... I believe it can manage aches and pains ... Wish we'd tried that alone before pred

[PMRpro Ambassador in reply to mrsQuics]

We have had homeopathic practitioners who are PMR/GCA patients on the forums in the past who have all said that while they may be able to help with reducing add-ons and side effects they cannot "cure" PMR and that anyone with GCA absolutely needs pred. One who had GCA did find she could improve her symptoms a lot - but only by using doses that they are told should never be used for thair patients.

[Klah]

It is hard to say...but I know people who keep some pred on hand for days like you describe. I think I would try the wait and see approach, but only for 1-2 days. 1-2m of prednisone isn’t going to send you down that road.

On-going Pain is not a good idea in my opinion. Wish you the best😊