Burning discomfort hamstrings

[LCHRISTOP10]

PMR 2016. GCA 10/17. Actemra good results, except mouth sores and frequent upper respiratory infections. Necessary to stop due to breast cancer, 11/18. Lumpectomy, radiation and currently taking Anastrozole(estrogen and progesterone blocker) Feeling well all summer and fall. Tapering gradually Prednisone 0.25mg every 2-3 weeks to 10.5mg. Recent routine CRP jumped to 17 with normal Sed rate. Was feeling well except 4-5 days of AC joint discomfort after new tricep exercise routine. Rheumatologist decided not to up Prednisone. To repeat labs in 2 weeks. Few days later, Friday, started burning discomfort r hamstring. Next morning progressed to left. Upped pred 2mg. Without stiffness or fatigue. No sensory loss. Feels better when up and about.Monday rheum upped pred to 20 mg x 2days then drop to 15 mg x 2 days. New labs drawn. No reported results yet. Stopped usual 1 1/2 mile daily walk on treadmill and have rested for 5 days. Without improvement after 2 days at 20mg. Scheduled for US liver this am for intermittent mild elevation of liver enzymes. Negative CT Abdomen 1/19. Any ideas regarding discomfort? PMR flare, steroid neuropathy, or related to hormone blocker pill? Why so complicated? Hope to talk with rheumy today or tomorrow. Have routine appnt with primary care provider tomorrow. Thanks. Reassuring “the wise family” is always available.

[SnazzyD]

Hello. So sorry you’re having to deal with all this and it complicated indeed. Three things spring to mind here. 1)You may have got to where you need to be for a while with Pred because a bit of a PMR has crept in. Inflammatory markers can be delayed in showing up inflammation (for some they never show) so it is possible that the dose got too low a couple of doses back and are only just showing. Why did the Rheumy up to 20mg when a 2mg increase helped? 2) Aromatase inhibitors can cause joint and muscle pain that can be quite severe. I know I’ve had it and have spoken to others with it too and getting out of bed in the morning tended to be the worst time. I refused it in the end back in 2005. 3) It is poss that your current exercise regime is too much or adding a new exercise has been too fast. Pred makes one much more prone to injury.

In an ideal world you would take a few things away to work it by process of elimination. The exercise is easy to stop to see if pains ease when the muscles heal. You might want to discuss stopping the aromatase inhibitor for a short spell to see if that lifts the clouds. It is a preventative not a curative so shouldn’t be too tricky, though that’s a your doctor’s call.

Anyway, I’m sure you’ll get more opinions here.

[LCHRISTOP10 in reply to SnazzyD]

Thank you for your prompt reply. I was not clear -4 days of 2 mg increase did not help. Rheumy thought increase to 20mg for 2 days and then 15 mg 2 days may calm things down. CRP was elevated approximately week before hamstring burning started. Surprised, as u say labs usually lag behind symptoms. Possibly, new shoulder stress, 95% better after few days, cytokines overfilled the bucket and pred could not keep up. I have not resumed exercise only rested.

[PMRpro Ambassador in reply to LCHRISTOP10]

I don't think you can be as sweeping as to say markers "usually" lag behind - often is the word I use.

[LCHRISTOP10 in reply to PMRpro]

Sorry for the slip. Was awake, hurting middle of night in USA.

[PMRpro Ambassador in reply to LCHRISTOP10]

What hurts in the night?

[LCHRISTOP10 in reply to PMRpro]

Burning discomfort bilateral hamstrings. Rheumatologist called today. CRP And Sed rate now both normal on 11/18 blood draw. Magnesium normal. Muscle enzymes normal. Kidney function normal. Abdominal US normal. Liver not enlarged and without evidence of fatty liver which he said may not show. Discussed Aromatase Inhibitors causing discomfort. He said he has seen that in patients. Will discuss with oncologist at next weeks visit. Rheumy did not have an answer. Instructed to decrease Prednisone to 15 x 3 days then drop to 12.5 for a week and reevaluate. I am fortunate to have a consultant who is available to his patients.