Fell down. Increase prednisone dose?

[Navion]

As if there isn't enough to worry about, I fell down when walking on Friday. I landed on my left side, on the scapular area. I definitely did something to my scapular area plus I either strained some intercostal muscles or cracked a rib. The pain is horrible for certain movements. Since then, my PMR symptoms seem worse. I am currently on 9 mg prednisone and 10 mg per week of methotrexate which I started 5 weeks ago. I really don't want to increase my prednisone with the pandemic but I'm wondering if I should for a few days. Any thoughts?

[jinasc]

Have you tried a couple of Paracetamol ?

A fall which causes pain can cause stress as well............

Increasing your pred, won't make you any more at risk. A call to your GP might be a good option..............

Other will be along shortly.

[Navion in reply to jinasc]

I did take some Tylenol arthritis and it helped. But I don't want to take much because I'm already worried about my liver being on methotrexate. My GP is fairly worthless as she is really slow about responding.

[SheffieldJane]

Have you spoken to your GP? I would. It maybe better to be on 5 mgs extra Prednisalone and stop the Methotrexate during the Pandemic because of its effect on the immune system. You do need medical help - even over the phone. Good luck!

[Navion in reply to SheffieldJane]

My rheumatologist handles my PMR. I will run it past her if I can get ahold of her. I hesitate to stop the methotrexate as Prednisone alone, even at higher doses, didn't decrease my pain more than maybe 60%, and didn't decrease my inflammation markers much at all, especially CRP. Even though the methotrexate hasn't helped with the pain yet, it has helped the stiffness and my inflammation markers are nearly normal.

[SheffieldJane in reply to Navion]

Yes of course that is between you and your Rheumatologist. I have not been started on Methotrexate due to the Pandemic but each case is different.

[Hidden]

Yikes...sounds painful. Having cracked a couple of ribs falling over a dog I sympathise. This bit of research suggests an increase due to relapses after falls. But I presume you have taken pain killers?one thing I know about broken ribs and intercostal muscles is you really have to rest them. No poking it, no testing to see where it hurts most (everywhere), its total rest, heat if you can bear it and pain relief. ... Have a read, maybe chat to Dr? And see where you go.

ncbi.nlm.nih.gov/pmc/articl...

[Navion in reply to Hidden]

Thanks, this is really helpful. I'll talk to my rheumatologist about it when I get hold of her.

[PMRpro Ambassador]

I was just going to ask Poops about that link - done!

My suspicion is that a fall may kick dormant myofascial pain syndrome (MPS) into life - it is often found alongside PMR. Even before PMR manifested I would have a flare of MPS - tripping over a kerb and trying to save myself, being on a bus that stopped suddenly but I didn't, the wrong pillow (so I always took mine with me), slipping down the bottom step, all sorts of things. And for me, a flare of PMR is always preceded by a flare of a back problem.

[Navion in reply to PMRpro]

Thanks.

[Hidden in reply to PMRpro]

That clumsiness is very familiar and for the sake of my back I had to learn not to do the reflex catch you do when something falls. It would leave me in agony. As would even jumping at a scary bit in a film or TV program. I always read up the plot of things I watch and get all the spoilers so there are few jumpy surprises. Maybe it'll be time to research good needling practitioners for suspected mps once this mess is over.

[HeronNS]

Avoid a pred increase unless you are certain it's PMR flaring. Do all the things people suggested, the heat and/or the cold, any painkiller you feel is safe for you. I had a nasty fall some years ago on my way to work. Worked all day in considerable pain. Got home in the early evening, collapsed into a chair and a few hours later, as the spasmed muscles relaxed, I felt better. This was, mind you, long before PMR. But it did make me aware how much tense muscles can cause pain, and referred pain along the nerves.