How do I know if I have PMR , I was diagnoised with GCA , in sept 2019 , I've experienced joint pain on and off for years ! Thankyou

[Jude85]

How do I know if I have PMR I was diagnosed with GCAin around sept 2019 I've suffered with painful joints on and off for years , but untill recently I've been pain free in this respect

Thankyou

[PMRpro Ambassador]

What dose pred did you start on for GCA, when and what dose are you at now? When you say "years" - how long? And only joints or muscles too?

[Jude85 in reply to PMRpro]

I initially was on 500ml infusions as an emergency ,

Then I was on 80 mls

This was then dropped very quickly by all accounts

I'm now on depo 80 mg im

And 5 mg taken by mouth

[PMRpro Ambassador in reply to Jude85]

It is possible that you are now at a total pred dose that is too low to manage PMR symptoms and that is why the pain has returned. However, PMR isn't really joint þain, it affects soft tissue, muscles and the structures surrounding the joints.

I don't understand why you are on depotmedrone and oral pred - corticosteroids are corticosteroids, however they are administered and it is possible to manage both PMR and even GCA using the injections alone, there was a patient on the forums who couldn't take oral pred and her GCA was managed well with depotmedrone. Prof Dasgupta did a study on using the injections for managing PMR.

[Jude85 in reply to Jude85]

I had painful knees often swollen

For about 10 years I have spondylosis , so some back and hip pain , I dosnt really notice if it was joints or muscles

I lost a lot of weight due to cancer , and then with the weight loss the pain , practically disappeared,

[PMRpro Ambassador in reply to Jude85]

That sounds more like a osteoarthritis problem - weight loss often improves that.

[Jude85 in reply to PMRpro]

Yes I had thought osteoporosis

Too !

And I had spoken to my rheum

In regards to too fast a drop in steriods,

That's when he gave the depo injection , I didn't ask why , but it seemed to help !

[PMRpro Ambassador in reply to Jude85]

Of course it helped - it isn't any different from upping the oral dose!!!

[Grammy80 in reply to PMRpro]

I'm curious??? I've never asked the doctor...but believe I was told the injectible steroids were 'kinder' to the liver....that between oral or injected the big difference is the process by which it is absorbed into the body. Maybe someone could shed some light on this. Also...what is the big difference/preference between prednisone and methylprednisolone? Absorption? I know methylpred is stronger...is that it? Thanks

[PMRpro Ambassador in reply to Grammy80]

Not sure if methyl pred has to be processed by the liver - prednisolone doesn't anyway so it is more reliable for patients who may have liver problems. Prednisone must be processed by the liver to give prednisolone which is the active form.

The methyl bit in methyl pred is claimed to give an increased antiinflammatory effect - all it did for me was make the adverse effects worse! I'd not had problems with oral prednisolone and have none with prednisone either. Methyl pred was awful, massive weight gain, skin and hair went mad, I grew a lovely black beard! And to add insult to injury it didn't manage the symptoms, even at 20mg/day. I switched to prednisoneThe advantage of the injections is that there is 100% bioavailability, it is all absorbed into the body unlike the oral versions.

[Grammy80 in reply to PMRpro]

Thanks so much...

[Jude85 in reply to PMRpro]

Thankyou , for your rather abrupt reply

Much appreciated

I love being patronised, whilst seeking help and support !

[Hidden in reply to Jude85]

I suspect the implied criticism was directed at the dr who didn't explain the process fully rather than patronising you. We hear stories of Dr's not explaining treatment protocols all the time and the dr should have explained that the injection was like upping the oral dose. The best advice and support you can get from us all is what sort of questions to ask when Dr's offer treatment.

[PMRpro Ambassador in reply to Jude85]

That wasn't patronising - and not patronising you even if it were. There have been a few posts recently about doctors making patients reduce their oral pred dose by giving them i.m. injections. Of course it helps - it is pred, but by another way of administration. It is the rheumies who aren't acting logically.