Injury Triggering Major Flare Up

[Christophene]

After 3 years now since PMR diagnosis, I tripped in my kitchen; the dishwasher door fell open and I tripped over it. I fell partially backwards , got up, and within a few minutes my right shoulder was killing me. I knew it was not broken or dislocated, not bruised or swollen. Iced it for two days.

I had been doing pretty well; this happened this past Monday. Now every PMR spot is inflamed, both shoulders, both arms, both hips, both thighs, both knees and back of my neck, not hurt in fall.

I can't find a comfortable position, and can't get my right arm , dominant side, on the steering wheel to drive. Feel clumsy, but angry at situation. I imagine any injury causes stress, and stress causes flare ups.

I see my GP for another depotmethylprednisisolone injection next week, but no one can really do anything about it; my daughter got a splint, but it was worse in that position.

Feel worse than before diagnosis. A real set back. Has this happened to anyone else.?

[Hidden]

Hi Christophene, there's a research paper on PMR and falls that argues a fall can cause a relapse and pred should be increased. As you are on injections I don't know what this would entail. 🌻

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

[Christophene in reply to Hidden]

Thanks for your reply. Now I know that relapse after a fall is par for the course. Notwithstanding the injections, I did take another 8mg of oral Prednisone yesterday and will do it again today I see the my GP who is giving the injections next week and will see what he thinks.

May be forced to go back to rheumatologist Thanks again.

[PMR48 in reply to Hidden]

thanks for sharing this article. I think I'm having a relapse of symptoms not after a fall but after a workout injury to my elbow. It makes logical sense to me that any injury can cause this. I'm about to try and increase my prep from 2mg to 5 and see what happens.

[Hidden in reply to PMR48]

Yes I think injuries that would normally cause a response probably need a blast. If you do it for 3 days to a week you can usually drop back down.

[Hidden]

As I mentioned in my profile, I had a severe thoracic back muscle injury after being on prednisone and doing well. Needed a big blast of prednisone to get back on track, as all thoracic muscles, front and back plus shoulders, neck etc , hurt at a level 7-8. It was like my PMR was untreated again. My theory is, all the pred is diverted to the inflammation from the injury. Very discouraging I know. I do hope extra pred if that’s what the dr does, will help. Give follow-up, please. Will want to know how you do. My best

[Christophene in reply to Hidden]

Thanks for your support. I think this disease wears us down physically and emotionally if there are no good days. Sorry about your fall; are you better now?

[Hidden in reply to Hidden]

Well if we have been on pred a while we don't get the shot of cortisol we would get naturally. I was reading yesterday that cortisol can go from "normal" 30mg to 300mg during surgery or other trauma. If we are on 7.5mg or less of pred we have no extra fake cortisol floating around the system.

[Christophene in reply to Hidden]

I also wonder how much the big blast dose was that got you back on track.?

[Hidden in reply to Christophene]

I was on 12.5 pred. Thought I was superwoman and tried to pull a planter pole out of the ground. With a normal healthy body it wouldn’t have been a problem, but with pred and PMR weakened muscles, that muscle/ ligament couldn’t handle it. Audible pop and then excruciating pain. Dr tried 30 mg without relief, then 3 days at 60. Worked wonders. Then rapid reduction. Can’t recall what I started back on after that. May have been 15-20. Taught me how extra careful I have to be. 😕

[lemarie1]

I am sorry that I don't understand whether you were still on a oral prednisone dose at this time or whether you had weaned off completely?

[PMRpro Ambassador]

How are you so sure that there is no damage done?

The problem with the i.m. injections is that the daily amount of pred released falls over the period and once it is low it may not be enough to both manage the PMR and cope with the stress of the trauma.