Is it PMR or something else?: I was diagnosed with... - PMRGCAuk

PMRGCAuk

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Is it PMR or something else?

Londonblue
Londonblue

I was diagnosed with PMR in May 2013 and have had numerous ups and downs with Prednisolone. My rheumatologist prescribed methotrexate two years ago to help me to reduce the steroids.

I am now on 1.5 mg daily, plus 15mg methotrexate (reduced from 20 in May on rheumatologist's advice due to side effects) weekly. I sought advice from this forum a few months ago (thank you, everyone!) and have been taking the reduction very slowly. This has been going well.

I should have seen my rheumatologist last week, but after 3 changes the appointment was cancelled and I await a new date 😡. I wanted to raise a new issue with her, which is that over the last month or so my arms are stiff and painful between shoulder and elbow. This improves with exercise but doesn't go away entirely. My arms are also quite weak, although I continue to swim, walk, do yoga regularly and have an active life. I'm in Cyprus at the moment, until mid October, and the heat has made no difference.

I'm not sure if this is PMR related, as my hips/thighs are okay and felt fine this morning after an hour's walk. With flares I've had before, my thighs have been very stiff and I've been unable to walk for long.

Do you think the problem is PMR related? I'd like your advice, please.

Thank you!

Eileen

9 Replies
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PMRpro
PMRproAmbassador

Have you tried taking a bit more pred for a few days to see if it helps? You can do that for up to a week to 10 days and drop straight back to the old dose if it makes no difference.

My flares are a bit different each time so that might be an answer. Had you been doing anything different in the week or so before it started?

Londonblue
Londonblue in reply to PMRpro

Hi PMRpro

I went back to 2mg for a week but it made no difference. I had alternated 2 and 1.5 daily for a couple of months before reducing to 1.5 daily about 3 weeks ago. It hasn't worsened since the last reduction though.

No, I hadn't been doing anything different before it started. I've just never had pain in my elbows before.

PMRpro
PMRproAmbassador in reply to Londonblue

No, I meant adding/going to 5mg for a few days to see if it is inflammation. 1mg isn't enough to clear out existing accumulated stuff.

Londonblue
Londonblue in reply to PMRpro

Thank you; I'll give it a try.

If it improves with exercise it could just be normal muscle pain and stiffness from either doing a bit too much , or the general muscle pain from the muscles getting weaker during PMR from inactivity , we all start to feel more aches and pains after reducing the dose as the Pred no longer masks the other pains.

If you are feeling benefit from exercise , keep it up but build it up slowly so that you don't add to the pain by overdoing it.

Don't use weights this can aggravate tight ligaments but try stretching and rotating exercises instead , Tai Chi , Light swimming or Aquafit or Nordic Walking as these are all good , moderate activities that help Arm and Shoulder muscle without putting pressure on the joints.

Taking Omega 3 and Magnesium as well as your Vitamin D can help , as well as heat pads or Paracetamol or a muscle rub like Flexiseq when it really aches.

If then you feel like it is a return of PMR symptoms that is causing radiating pain down your arm you might need to increase your dose , do speak to the GP about it too while you wait for your Rheumy.

You could even ask to be referred to Physiotherapy to get some advice on the right exercises to help .

Thank you for your help.

I was diagnosed with tendonitis in both shoulders about 2 years ago and had physiotherapy. I resumed the exercises in March this year, as advised by the rheumatologist, when the problems returned (I'm still doing them).

I've been a regular swimmer for about 25 years. After PMR struck, it was difficult but I carried on doing as much as I could, although it took a while to get back to my half hour routine, 3 or 4 times weekly. I do regular Nordic walking and yoga, both of which are helpful. I thought because I'm not finding walking difficult, and am able to walk reasonable distances without problems, PMR wasn't responsible this time. PMR pro had advised that each flare can be very different, however.

I avoid taking more pills if I can, however omega 3 seemed to make no difference. I haven't tried magnesium though. As I'm not in the UK at the moment, I'll see how I get on with paracetamol on bad days.

I think you have to be careful with yoga because the stretches are intense, especially if it’s Hatha yoga and you hold positions for a long time. There are adaptive poses with less pressure on the joints and blood flow - your instructor could probably help.

Thank you, Thelmarina

My regular instructor is very good about adapting poses, and I don't try to exceed my limitations!

Brilliant!

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