exercize

[kate24]

My friend with pmr has another problem with severe back pain.

He was doing ok on 4 pred for a month, his doctors said doing well,

inflammation down. But then he went to the gym, sent by

his nhs physio for gym workouts for his back pain.

Now his constant pain all over has returned. Of course he

shouldnt have done the exercizes, not gentle very vigorous.

Now he is wondering if he should up his pred dosage for awhile.

Taper back down again slowly.

Or to leave it as is, and hope the muscular pains will go away in a few weeks.

Could the exercizes have even induced a flare? Is the body demanding more pred to compensate for all that additional physical stress?

Any advice what to do now appreciated. (he already decided to give up the gym)

[PMRpro Ambassador]

The pred is only managing the inflammation - the actual underlying autoimmune disorder is not changed in any way by the pred, it chugs along in the background unchanged and has a similar effect on the muscles to what happens in proper flu, leaving them intolerant of acute exercise. They develop delayed onset muscle soreness in response to exercise which tends to be far worse than usual and also takes longer to reolve.

The NHS physio should not have just sent him to the gym - but it is fairly typical, they simply don't understand the effect PMR has on the body, even if the symptoms are/were under control with pred, and we meet people in a similar situation quite often.

I really am not sure raising the pred dose will help - just rest and TLC until the muscles recover. But since the problem is very possibly myofascial pain syndrome - I really don't understand what makes the physio think exposing stressed back muscles that are probably in spasm to more stress is going to improve his back pain. But then - I have experienced both the UK and the Germanic attitude to dealing with back problems! FIRST you have to get the muscles into a fit state - then you can strengthen them with exercises.

[kate24 in reply to PMRpro]

I thank you for quick response!

[Hidden in reply to kate24]

And if/when he goes back...gently does it. Over the counter pain killers should help with the muscle pain. Most of us overdo it at least once and have to have a good rest. If he is suffering with muscular/myofascial pain there are gentle stretches that can be done once his body has got over the shock.

redboxfitness.com/myofascia...

[MaryA_ in reply to kate24]

I’ve taken Tylenol to help with the muscle pain when I’ve over done. Does seem to help me

[PMRCanada in reply to MaryA_]

Me too. My daughter stayed overnight and helped me clean out our attic (it hadn’t been sorted since we moved into the house 1.5 years ago!). I directed and sorted empty totes and swept, she did all the heavy lifting, carrying stuff up/down two sets of stairs. Then we coloured each other’s hair (hers is long and thick). Even though we took a few breaks, I woke up today sore, so all the leftover summer clothes and donations to good will will stay unsorted for another day while I rested. Tylenol helps as does the hot tub.

I’ve tried physio however once the exercises included weights, my muscles began to ache. Sure wish there were physiotherapists who had a background knowledge in PMR.

Sure hope your friend gets some relief from his back pain. Rest and recuperation is best. If they wish to increase activity in the future, do so building up slowly with adequate rest in between.

[PMRpro Ambassador in reply to PMRCanada]

"wish there were physiotherapists who had a background knowledge in PMR"

it never ceases to amaze me here - in a country where the incidence of PMR is relatively low the physios are totally up to speed!!

[Purplecrow]

To answer your question..."could the exercises have induced a flare", in my experience, yes. I have found that nearly any excessive use of the muscles, particularly upper back and shoulders, will trigger a flare of some degree.

My last flare was induced by an aggressive massage of my shoulders and upper back. I have been on raised level of pred for past 6 weeks, only today beginning the taper process again.

Jerri,

PMR diagnosed 2013