Can you explain the difference between PMR pain and withdrawal symptoms?

[Pirnilla]

I siffer from pain but I don’t know which sort of pain.

Have you experienced withdrawal symptoms and can tell me about how you differ that pain from PMR pain?

[Hidden]

Hi pirnilla...it's more the timing as well as the pains (for me). Steroid withdrawal starts 1 to 4 days after you reduce. My right shoulder really hurt and I couldn't move it properly. At first I thought it was a flare and upped the dose.

If the pain starts about a week or two afterwards, my thighs started to hurt. Both sides this time. It was the very familiar leg pain and stiffness.

[SnazzyD]

Hello, coming at this from a different angle having had just GCA, I can say what I get without the PMR. Timings have changed a bit with different dose ranges but generally from day 1-4 I get an all over cloud of pain which can be quite intense, fatigue and sweats. The pain is particularly in the shoulders. with doses roughly above 10mg it lasted about 2-5 days but at lower doses and it can be a week. Whether this has anything to do with adrenal insufficiency I don’t know.

[DorsetLady PMRGCAuk volunteer]

As poopadoop says timing should tell whether withdrawal or flare. Immediately and only lasting a few days - SW; “original type” pains after a week or two - flare.

For me, steroid withdrawal was a general feeling if malaise, not pain as such coupled with short temperedness - I always thought it was like pre-menstrual tension.

[Soraya_PMR]

Mine was pain starting the evening of day one, worse on day two, fading on day three (steroid withdrawal) Paracetamol took the edge off.

PMR resurgence due to a low dose was from day 7+, increasing each day. Paracetamol did not help.

I had the need to sleep a lot for a week at each drop. Now I’m at low doses I ALWAYS have the need to sleep a lot!

[GOOD_GRIEF]

Withdrawal pain comes on and fades over a few days, usually less than a week.

PMR pain comes on and stays or gets worse.

Hope this helps....

[PMRpro Ambassador]

Depends a bit on how big the reduction is - it is possible to experience a moderate drop with immediate development of pain as the dose dropped which then improves over subsequent days. However - if the drop is too big the steroid withdrawal "rheumatism" and other symptoms MAY last a LOT longer. I have heard people who find it can last as much as a month. However, it tends not to get worse.

A flare of PMR symptoms CAN start quickly if the drop is too big, within a day or so. But it then tends to get worse with time.

That is why we push the concept of slow tapers - tiny steps down and not too often.

[Thelmarina]

It is tricky, especially if you’re over seventy and are not sure whether or not some stiffnesses etc are due to wear and tear. However, for me, PMG symptoms are the neck and shoulder pain, very specific and horrid. If I get a flicker of that pain I stick where I am for a few days before continuing a taper, (I would increase dosage if that didn’t work). It’s like your body is your barometer!