Unilateral Break-out pain from PMR

[sjbeck]

I was diagnosed with poly myalgia rheumatic 6 months ago. Started on 20 mg of prednisone with excellent pain relief. However during the 6 months, I have had break-out pain that is unilateral. I had pain in my right rib cage that caused so much discomfort when I walked because I couldn't breathe d/t the increase in my respirations from walking. Currently I have pain in my right shoulder during the night and early morning. Then it goes away for most of the day. Does anyone have else have unilateral break out pain. I am down to 10 mg Prednisone now.

Thank you

Susan in USA

[DorsetLady PMRGCAuk volunteer]

I would say you probably reduced below the level of Pred you actually need. 6 months into your illness is still very active.

Just because you are on medication doesn’t mean the PMR is cured, in fact there is no cure, but it is self limiting.

All the Pred does is control the inflammation caused by the PMR - but the dose needs to be high enough to do that.

Might be worth going back up to 15mg for a few days and see if that helps - if so then drop back down to say 12mg, stay there fir a couple of weeks - and don’t reduce unless you have no symptoms.

If the increase doesn’t work, then you need to discuss with doctor.

[PMRpro Ambassador]

You aren't supposed to be relentlessly reducing your dose of pred to zero - you are looking for the lowest dose that gives the same relief as the starting dose did. However - what you describe could be costochondritis or due to myofascial pain syndrome. It doesn't really sound like "just" PMR.

[Hidden]

Hi..in the first year when I was forced or at least directed by the Dr to reduce in the first 6mths from 15mg to 8mg I had all kinds of unilateral pain my right shoulder and chostocondritis as pmrpro suggests can be add ons to pmr, But it usually indicated I was too low on pred. At 6 to 8mths in I felt terrible and markers were higher than at diagnosis and the dr increased me back to 15mg.

It's always worth getting new pains checked out if the are persistent and if a brief blast of pred does not help.

[sjbeck]

Thank you all for your comments. It has been helpful. I decided yesterday to increase Prednisone to 12.5 for a few days. My right should pain is already a little better after only one dose.

[PMRpro Ambassador in reply to sjbeck]

That does sound as if it could be shoulder bursitis - and it might be worth speaking to your doctor about a local steroid injection. In the current climate though it could take a while ...