Just when I thought things had gone back to normal (well, symptoms back under control via preds) . This evening both wrists and forearms are aching like mad and some mild stiffness has returned to my upper arms!
I returned to work on Tuesday so have been doing quite a lot of manual work for the past 2 days. Are these aches due to PMR or simply because I have been over doing it by returning back to work???
There you have it Leepeelee, you have overused those muscle groups. I walked
too much/far yesterday and my hamstrings feel like I ran a marathon. Rest and the application of heat and over the counter painkillers my help, perhaps a cream like Flexiseq.
Quite possibly both. Your muscles will have lost condition. I found that as I popped out of higher doses I had tendonitis or a predisposition to it. My lower arms could not tolerate any manual work and my Achilles and pelvic tendons were jolly flakey too. It has taken 18m of improvement for my arms to get back to being useful. However, bare in mind that my tendons were probably still quietly upset from taking Quinolone antibiotics some years back. You could try a tennis elbow strap from a pharmacy perhaps? It supports the tendons just below the elbow on the forearm.
Both !
Just going back to work will have felt like a big jump for your body but repetitive work with the arms that you haven't done for a while can cause Aches and Pains for the Healthy , double that and more with Chronic Pain and PMR.
Take some rests in-between work activity and less physical arm work.
Do some gentle joint and hand rotations through the day to prevent them getting stiff from being in the same or an odd position.
Good luck
You have to do your bit - the pred manages the inflammation, that is all. It relieves the pain and stiffness to allow a better quality of life but it does nothing about that actual illness - just you might use paracetamol and Lemsip-type stuff to relieve flu symptoms but the viral infection is still chugging away in the background and attacking your body. The underlying autoimmune cause of PMR is still there, attacking your body tissues and leaving your muscles intolerant of acute exercise. You are likely to develop delayed onset muscle soreness (DOMS) if you overuse any muscles - walking too far or carrying heavy items or just doing repetive movements - and it will take longer to recover from it.
Your aches are almost certainly due to the extra actions at work - sometimes it helps to do the action for a short time and then rest those muscles by doing a different action. Did you have a staged return to work?
I am a self employed builder so I have no choice but to return to work, if I don’t work, I don’t get paid. I have been taking things much more carefully since the PMR was diagnosed (well, not yet 100% diagnosed but hopefully I should know for sure when I see the Rheumatologist, still waiting for the appointment!)
The blood test results done by my Dr were 1st ESR 47, then 1 week later after preds had taken effect, 2nd ESR 20
This is how my Dr has diagnosed PMR along with the symptoms being those which would suggest PMR.
This evening, I seem to have severe upper arm pain which is worsening with rest. I’m wondering if I should increase the pred dose back up to 20mg although I am reluctant to do this as it was so difficult on my last taper!
So very frustrating
I do fully get the "if I don't work, I don't get paid" - I also worked as a freelance translator. and while I know it isn't the same, I had awful arm pain when I'd had to work a lot - again repetitive use of the same muscles.
But nothing can alter the fact that the pred only relieves the inflammation and has no effect on the disease process itself, leaving your muscles in a poor state to carry out physical tasks. More pred may not help either as too much pred leaves the muscles in a less than ideal physical state.
My experience of delayed onset muscle soreness, the muscle soreness that we get from overdoing things, is that when you sit it worsens - so I'd suspect that is what you are experiencing.
Thank you.
Do you think a diagnosis based on ESR blood tests and symptoms is enough? What would a Rheumatologist be able do to get a more positive diagnosis?
That is the normal procedure - there is no definitive test for PMR and it is a clinical diagnosis, i.e. on the basis of signs and symptoms and, to a small extent, the response to pred. Before being put on pred they could do a PET-CT which will show up areas of inflammation so if there is enough they can see if the typical areas are inflamed. Once you are on pred they like you to reduce the dose to a fairly low level if they hope to get a result with at PET scan as even 10mg can be enough to suppress the process.
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Ultrasound on Shoulders, Elbows and Wrists
