Jaw pain and prednisolone: Evening all. Me again... - PMRGCAuk

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Jaw pain and prednisolone

Linda3009 profile image
Linda3009
β€’32 Replies

Evening all. Me again !

Each time I've seen a doctor on this whole gca journey, they've seemed to lose interest when I confess that I haven't had any jaw pain on chewing. ( despite the fact that we know that less than half of people with gca get jaw pain)

In fact, the rheumatologist cited the absence as one of the reasons for saying I have "probable" gca.

Anyway. To business. On the advice of said rheumatologist (and probably against your better judgements) I've started to reduce my prednisolone dose.

I'm now on day 4 of 40mg having been on at least 50mg for about 9 weeks (and believe me I have the cheeks to prove it! 😱

Interestingly, I've started to get a fair bit of pain in my jaw (mandibular joint area) when chewing.

Oh the irony! The thing is , could this be due to steroid withdrawal or is it the whole beastly gca coming back?

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Linda3009 profile image
Linda3009
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PMRpro profile image
PMRproAmbassador

I fear it sounds suspiciously like the beast ...

So maybe they will believe you now?????????

Linda3009 profile image
Linda3009 in reply to PMRpro

I wouldn't put money on it.

I think I must have a naturally shifty air 🀨

HeronNS profile image
HeronNS in reply to Linda3009

Yes, you are simply out to get your pred fix aren't you! πŸ€ͺ I mean, we all love it so much!

Linda3009 profile image
Linda3009 in reply to HeronNS

Haha.

Although the moon face has done wonders for my wrinkles πŸ˜‚

HeronNS profile image
HeronNS in reply to Linda3009

πŸ˜‰

Blearyeyed profile image
Blearyeyed

Hope springs eternal Linda!

Maybe the Rheumy chose to get you to taper quickly just to be able to confirm the GCA diagnosis when your old and new symptoms started to raise their ugly heads above the Pred again.

If it continues , past a few more days and things get worse and keep going down hill get on that phone to the Rheumys Secretary and tell him ( or her) the lovely news .

They can finally rubber stamp the GCA and will hopefully recommend you increase you dose again for awhile longer until the inflammation is firmly under control.

Take extra special care and pace yourself with lots of rests in the meantime.

And don't be afraid to start contacting the Doctor if you need any help .

Linda3009 profile image
Linda3009 in reply to Blearyeyed

Thanks.

That's good advice (as always) 😊

Will keep a close eye on things over the weekend .......

PMRpro profile image
PMRproAmbassador in reply to Linda3009

It's still only Wednesday!

Linda3009 profile image
Linda3009 in reply to PMRpro

πŸ™ˆ

jinasc profile image
jinasc

How long ar you supposed to be on 40mg before the next drop?

In the meantime, Blurry eyes, flashes etc - off to A&E or up the pred back to where you started, which I presume was 60mg and then contact both GP and Rheumy.

Your sight not his/hers.

Linda3009 profile image
Linda3009 in reply to jinasc

I've got another 10 days on 40mg then the plan is to drop to 30mg.

I asked the rheum what to do if symptoms returned at a lower dose and he said manage them. On no account increase the dose.

Can't help thinking this is Duff advice.

jinasc profile image
jinasc in reply to Linda3009

I would not drop more than 10% at a time at this time, so do the math.

I love your "Duff advice" response. .

PMRpro profile image
PMRproAmbassador in reply to Linda3009

Dear lord - and HOW are you to manage them without pred? What a stupid thing to say. All pred does is MANAGE the symptoms. Nothing else does - so what now sir??????

Linda3009 profile image
Linda3009 in reply to PMRpro

It's true. I do seem to have had spectacularly bad luck on the clinical front so far.

In other news however, I tried the "chewing gum test" and I failed.

Not sure what's going on there, but my jaw feels like it's going to dislocate, not really cramping pain..

I'm taking it one day at a time but have an eagle eye open for any sight threatening symptoms

Thanks again everyone for the advice and support. 😊

in reply to Linda3009

All you need now is to find previously acceptable spicy food/curry too hot and you have several clues to what may be going on. Hopefully drs will pick up on one!πŸ˜‰

ncbi.nlm.nih.gov/pmc/articl...

PMRpro profile image
PMRproAmbassador in reply to

Like the concept of a weekly curry for monitoring disease status!!!!

in reply to PMRpro

I definitely can't eat spicy like I used to. That's what made me look for research. I like the quirky little bits like chewing gum etc.

Linda3009 profile image
Linda3009 in reply to

Wow that's very interesting.

I've had constant pins and needles in my tongue for weeks now. All doctors have merely shrugged and suggested it's due to prednisolone.

Am more than willing to attempt the curry test in (in the interests of science, obviously) πŸ˜‰

in reply to Linda3009

Always in the interest of science obviously!🌻

in reply to Linda3009

I used Colgate toothpaste at the weekend as only one available during family visit. My mouth is full of ulcers and sore bits. I try and avoid it where I can but forgot my washbag. 😁

PMRpro profile image
PMRproAmbassador in reply to

A couple of days of no toothpaste wouldn't have been the end of the world and surely preferable?

Blearyeyed profile image
Blearyeyed in reply to

Have you got any of those hydrocortisone muco- adhesive buccal tablets for your ulcers , you can buy them over the counter , they do help , I have them from the Behcets clinic recommendations for mine , they can be used while on other steroids .

Other tips from Behcets sufferers are flat full sugar coke swill !!! I prefer a swill and swoosh with very fizzy sparkling mineral or tonic water before popping the tablet on to clean the sites.

Strong toothpastes and certain mouthwashes make them worse.

Encouraging your saliva if your mouth gets dry with a sour lozenge , or a little chunk of pineapple followed by a swill of water helps ease the pain too.

PMRpro profile image
PMRproAmbassador in reply to Linda3009

Was it there pre-pred?

Linda3009 profile image
Linda3009 in reply to PMRpro

Well that's the thing, it wasn't but it appeared when I was told to lower the dose from 70mg to 50mg on day 9

I also have burning/pins and needles on my back

PMRpro profile image
PMRproAmbassador in reply to Linda3009

How strange - but did the reduction result in a flare of other symptoms?

Linda3009 profile image
Linda3009 in reply to PMRpro

I started getting severe cramp in both legs and feet

PMRpro profile image
PMRproAmbassador in reply to Linda3009

No doubt you have an atypical label ;)

Linda3009 profile image
Linda3009 in reply to PMRpro

Well who would have guessed? πŸ˜‚

PMRpro profile image
PMRproAmbassador in reply to Linda3009

Well quite!!!! πŸ˜‚

SheffieldJane profile image
SheffieldJane

Crikey! I hope your brutes of doctors are satisfied now. Needless to say, pause or increase slightly, it’s gearing up by the sound of it. Definitely sounds duff to me.

Hi Linda,

Did you have jaw pain when initially diagnosed? Your doctor seems burnt out ,ignorant.or negligent. Jaw pain, chewing or not, is a symptom of GPA. Usually with chewing. But not always.

Reducing 10mg at once is awful if he told you to do that. I would go back to 50 and see if the jaw pain disappears. Not every symptom we patients have are related to C-ANCA, but a 10mg drop with return of symptoms in 4 days says to me find a new doctor quickly.

Even "garden variety" TMJ is now being treated with a Medrol pack;(called in US;) a short course under 2 weeks with tapering built in. I had it years ago, and it was not vasculitis related then, but it's really painful and annoying. I was prescribed a Medrol Pack and the pain was gone in less than 3 days, long before this now 3 year journey has begun for me.

I don't have GCA, but I was originally thought to have it b/c I had the PR3 antibody on C-ANCA testing. That's another story. I was downgraded to PMR by a smart vasculitis specialist at Johns Hopkins University Vasculitis Clinic in Baltimore, MD; I waited 5 months to see her, but it was well worth it.

Go back up to 50, and find another doctor with experience in GPA..That is what I would do.

I'm sure you don't like your cheeks. I recently found a scholarly arrticle published in the British Journal of Rheumatology from 1997 that says injected intramuscular depot methylprednisone every 3-4 weeks does not cause moon face, hump back, almost no fractures , less weight gain and removes many, if not all, the side effects we don't like. My dose started at 16; I was down to 4, felt miserable, and went up to 8mg and now feel well enough to go to physical therapy. My spirits are back.

I looked for the article just now and can't find it. Will send citation when I find it.

But do think of yourself first; if you need 50,, you need 50. Be kind to yourself. Don't suffer. Your taper must be very slow. I am sure the others have said that.

How long since your diagnosis?

Linda3009 profile image
Linda3009

Hi Christophene

I saw the rheum 2 weeks ago and he said it was " probable" GCA.

I've just had a copy of the letter he's sent to my GP in which he states that although my presenting symptoms were indicative of GCA the negative bloods and biopsy would say otherwise.

He also makes it clear that even in the event of the symptoms returning the dose MUST NOT be increased.

He's going to review me in 6 weeks.

. I feel like I've got nowhere to turn. My GP is too afraid of going against a consultant to do anything and if I phone the consultants know that he won't agree an I increase in dose.

To answer your initial question, the jaw discomfort is new. I've had it for about a week now, since the dose went down to 40mg.

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