Is it Polymyalgia?

[Anglogreek]

I am a generally healthy 53 year old guy. About eight weeks ago, I started going to the gym after a long break and doing weights, nothing too extreme. A few days after I started, the muscles in my arms began aching very acutely. I thought I had overdone it so stopped the gym to let the pain subside. Alas, here I am eight weeks later and the pain is excruciating, mostly in the mornings. I now know it has nothing to do with the weights and suspect that I have polymyalgia. I had a blood test at my GP’s and the inflammation levels were high but not high enough for him to offer a definitive diagnosis. I am seeing a rheumatologist this Friday. My arms are aching terribly and I feel like some of the aching has migrated to my hips and thighs. I also have a slight tingling in my fingers but then again I have often had that sensation. I am writing this post because it is the first time I have suffered from anything like this and am feeling a little worried about it all. Thanks for reading!

[HeronNS]

It could be PMR. Like you I had somewhat raised inflammation markers, dismissed by the doctor as "normal" for my age. In the end, over a year after I first developed symptoms, I was given the prednisone test by a different doctor and after miraculous response PMR diagnosis was confirmed. Once you are diagnosed please don't worry about prednisone. It really is all we have, and you only stay on the starting dose for a few weeks. A very slow and careful taper brings you to a lower dose which maintains symptoms control until PMR goes into remission - which may take up to six years sometimes less sometimes more. I am pleased you are seeing a rheumatologist soon. You are within the accepted age range for PMR, sometimes people under sixty or even seventy are told they are too young!

In the meantime, should you develop any visual symptoms and/or severe neck pain or headache go directly to the emergency department to be checked for GCA. Others will be along, probably when the UK and Europe wake up. Take care, rest!

[Anglogreek in reply to HeronNS]

Many thanks Heron for your thoughtful reply. I have read about GCA and am a little worried because I am off to Mexico in two weeks for ten days, and hope nothing happens while I am there. Also, I have been advised not to start any possible steroid therapy while I am away just in case there are adverse reactions in my body. Thanks again for taking the time to reply.

[IslandRN]

Are you able to raise your arms and wash your hair, put on deodorant, get dressed without pain? Are you having difficulty getting out of a chair or getting on/off the toilet? PMR pain is bilateral and a rapid onset with normal presentation upper neck/ shoulders/upper arms pain/stiffness and pelvic girdle (hip and upper thighs) pain/stiffness. About 30% of us have normal lab values and a PMR diagnosis is made based on symptoms as described and rapid response to prednisone (nothing else works- not pain meds, not muscle relaxers, not Motrin only prednisone. It sounds plausible based on your symptoms you could very well have PMR and wish your GP would have given you a dosepak or some prednisone to see if it helped as if your symptoms improved by 70% or better within 48 hours it would have confirmed PMR and you would not have to suffer a whole week. Good Luck!

[Anglogreek in reply to IslandRN]

Many thanks Island for your helpful reply. I will definitely mention prednisone to the rheumatologist I see on Friday and hopefully he can prescribe some.

[PMRpro Ambassador]

How raised are the ESR/CRP? Not that that has much meaning - up to 1 in 5 patients with PMR or GCA has markers that remain within the normal range. That doesn't mean they aren't raised for them - the range for ESR is 1-20 and that is for a large population (10,000+) of healthy people, not for one person. If your personal normal is 4 (like me) then a level of 19 is significantly raised but remains "within normal range" so the average doctor won;t remark on it.

[Anglogreek in reply to PMRpro]

I'm not sure what my normal levels are - I shall call my GP and find out. But thanks for the pointer, I appreciate it.

[PMRpro Ambassador in reply to Anglogreek]

Few of us do know - how often would a GP check ESR and CRP for anything else? But the GP should bear it in mind - and many don;t know that a fifth of patients have normal levels. and it is more common in the younger patients.

[Hidden]

Unfortunately there's no "definitive" diagnosis for pmr as yet. Just a collection of symptoms that are significantly controlled by pred. At least you have a referral to rheumy, they usually test for conditions that can be diagnosed via specific tests like lupus, rheumatoid arthritis etc . Once discounted, pmr might be the fall back position and hope pred will help significantly. Good luck and let us know the outcome.

P. S. They may suggest you are too young.... The new NICE guidelines in UK for drs managing pmr have set the age at 40years onwards now. Many on here started symptoms in eay 50s and we have several members in their 40s.

[Anglogreek]

Thanks Poopadopps, I appreciate your taking the time to reply. I shall keep you all posted as to what the rheumatologist says and if I get the PMR diagnosis...

[Cycleman]

Similar to my story, though in my case it was splitting wood for 5 hours with a heavy maul. First my shoulders and upper arms, then it spread to my hips and hamstrings all within 3-4 days. I could barely move, get dressed or get in or out of bed. Zero sleep.

The doctor sent me immediately for a blood test but wrote a prescription for 15 mg Pred immediately. Rang me later to say that he had received results of one of the inflammatory markers ( high-ish) and told me take the Pred.( miraculous results)

There is no definitive diagnosis for PMR! Symptoms and inflamm markers are key indicators but the clincher is your response to Pred.

[Anglogreek in reply to Cycleman]

Thanks Cycleman, I am hoping I can start on the Pred very soon, the pain is so bad.

[sueysue]

My hubby was diagnosed with this a few weeks ago. He was started on steroids and the pain ceased within a few days. He has got to stay on them for a good few months

[Hidden in reply to sueysue]

Usually 2 years plus. Median time for pred treatment 5.9 years. But some men do seem to get lucky and hit the shorter end.