Too little pred or too much gardening?

[Norma1610]

Hello all,

I've been taking pred for just over 3 weeks now. I started on 10mg for about a week and then because my symptoms weren't totally under control, my GP suggested upping to 15mg. After 2 weeks on 15mg, I'm feeling much better (probably at least 90% better) so I did a bit of gardening yesterday which included moving a large bag of compost into the shed I now have tight and achy shoulders and am a bit fed up because I was feeling almost normal. So what now? My GP has given me some leeway with my dosage up to 25mg. Do I increase the dose up to 20mg or do I wait a few days and hope things settle? I'm having my first set of blood tests next week to see how things are going and wondered if that might give some pointers.

[PMRpro Ambassador]

No - the action you need to get your head around is limiting your physical activities! What you are experiencing is normal post-activity muscle soreness and pred is unlikely to deal with that. I'd stick at 15mg since you have had such a good response to it. And do whatever you would normally do for sore muscles.

The pred is only managing the inflammation - and so relieving the symptoms. It does nothing to change the actual underlying autoimmune cause of the inflammation - that chugs along in the background, attacking the body tissues and leaving muscles intolerant of acute exercise. You will probably get back to it - but it will take time and training, training that starts from a very low level. That doesn't include weightlifting a large bag of compost! The result is you will develop DOMS more easily than you were used to and it will take longer than usual to resolve.

10mg is a very low starting dose - and to be honest I don't understand why doctors insist on using it. If you are going to manage on a low dose then 15mg will work, you will get a good result quickly and you will have few problems tapering the dose. But starting there in a patient who needs a lot more will just expose them to a pred dose that does nothing except expose them to pred and delay them getting relief.

It will get better - just it takes patience

[Norma1610 in reply to PMRpro]

Thank you so much. I'm probably being a bit stupid here but what is DOMS? I was started on 10mg of pred due to the current situation with the virus. My GP said pred wouldn't make me more likely to catch it but could possibly make me more ill if I did. So he was trying to go up rather than down in order to get to the right level and I accepted that as reasonable in these uncertain times. I'm sure I'm not the only person who finds the fact that my ability to do things is now limited. On the other hand, a good excuse to sit on the settee and let my other half do all the hard work!

[PMRpro Ambassador in reply to Norma1610]

Delayed Onset Muscle Soreness - the sore muscles you get the day after overdoing exercise, as opposed to the muscle pain you feel during exercise.

Exactly - become the Supervisor! Nothing heavier than a mug of tea???????

[Yellowbluebell in reply to Norma1610]

Its what I have done. My husband no longer pulls up my precious flower mistaking them for weeds. Hes also busy building planters which keeps him out of my way. YBB

[DorsetLady PMRGCAuk volunteer]

I moved a large bag of compost the other day - and it nearly killed me! ..and I don’t have GCA any longer nor on Pred!

Not even contemplated in my illness days.😳

PMRpro has said everything I would.

[Norma1610 in reply to DorsetLady]

Thank you so much. It's so reassuring to know that all you kind folk are willing to take the time and trouble to be helpful and give such good advice.

[Birdsong69]

Sounds like we are paralleling. I felt so much better on 15 mg. which the doctor started me on.Have done simple chores which were ok but dropping to 12.5 mg doing similar chores set off the aches and pains. Talking to doctor again to check if I can up to 15mg or will I have to wait a bit longer to see if things improve. Noted that advice on this website under exercise ect suggest gentle exercise, and simple a chore once a day. Just have to take it day by day if new to this condition. Keep in touch and best wishes.

[Norma1610]

I'm all in favour of a simple chore every day Because my GP was willing to allow me to go as high as 25g, I'm hoping he'll let me stay on 15g for at least another month before I start to taper. I tried to hold out for 5 months before I finally gave in and spoke about pred so would really like to have a 'normal' couple of months before I have to change things. I'm also hoping to be able to use some of the really slow tapers on here. But we'll see Best wishes and thank you for getting in touch

[Cyclegirl54]

Hi, I’ve done similar, got too excited about the gardening and overdid it and had sore arms afterwards. Take it easy 🌸

[Norma1610]

Thank you - I will.

[Thelmarina]

Sounds as if you’ve overdone it, so easy when gardening! It’s not just the polymyalgia I think, but the fact that we are not as physically active and muscle tone isn’t as great either. I suggest an alarm so that you don’t garden too much and know when it’s time to stop. Then time for a sit down and cup of tea 😀. I did the same as you and it took several days of tlc before the aches and pains to calm down. I didn’t up the pred. 🌺

[Norma1610]

Thank you. I think you're right and I haven't upped the pred. If I didn't have pmr, I'd just be thinking I'd done too much and accept the sore muscles would go away. The fear of taking a step back and being in pain again scares me a lot .