I've just seen the GP who thinks I probably have PMR. Dr Google had already suggested this when I looked up my symptoms of very painful neck, arms, buttocks and hips in the morning, to the extent that getting out of bed is sometimes almost impossible.
The GP has arranged for blood tests. However he said that if PMR is diagnosed, there is a problem with me taking corticosteroids, as in the past I had idiopathic acute pancreatitis. For this reason, even ibuprofen, which has been helpful in getting me moving, is not advised. He will refer me to a rheumatologist for advice.
Has anyone else had contraindications for steroids?
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Melti
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As far as I can see the association between steroids and pancreatitis is disputed despite a long history of it being associated - maybe incorrectly? But the right person to adjudicate will be a specialist.
Thank you PMR Mod for your reply and welcome. I'll wait to see what happens, and if / when I get to see the specialist. I too looked and can see the link is somewhat tenuous, but certainly don't want pancreatitis again, but would love to subdue this pain and indisposition. In the meantime I'll keep taking the ibuprofen (over the counter) as it certainly helps and I really really need to keep moving.
Ibuprofen helps? Although there are suggestions for its use in PMR the majority of patients find that while it may help other pains, it does little for PMR pain. It might help some forms of inflammatory arthritis though. The use of NSAIDs in PMR is discouraged in the 2015 Recommendations:
After a quick look I couldn’t see an overwhelming consensus that it was contraindicated. As always in situations where there are or might be conflicting actions, the risk benefit assessment needs to be made, in this case by someone who understands the implications of not treating the PMR with Pred. So far no other treatments have proved to be as effective as Pred though other drugs are used to aid reduction but they are certainly not harmless.
Thank you Snazzy. I looked too and any link seemed somewhat tenuous. I really need to keep moving, this sudden indisposition has completely floored me! The GP mentioned something mexa.... Sorry can't remember the full name. I'll see what the Rheumatologist says if / when I eventually get to see them (sic)
Methotrexate? Sometimes used as a steroid sparer but it is not without its risks and isn’t normally used instead of Pred for initial treatment. Do ask to be referred to a Rheumatologist especially if the GP thinks you are a person who can’t take the normal medication.
The GP can't put you on methotrexate - it must be initiated by a specialist although GPs sometimes provide the follow-up prescriptions in reponse to lab results.
Yes, I think that was what the GPsaid - the rheumatologist might prescribe the methotrexate. however first waiting for blood tests and referral. I suppose I am a bit disappointed as I thought GP might give me pred right away and I would get some relief! Have waited a bit for GP appointment, with Christmas and New Year hols. Normally our GP surgery is excellent re appointments.
Yes ibuprofen really does help, but I'll read up on the advice - thank you!
I caanot take Ibuprofin, and was told that it did not help with PMR. Tylenol does not help either, although can give a little relief for the osteoarthritis.
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