Still wondering if it’s a flare or osteoarthritis

[Mstiles]

Hello all,

I posted a few days ago about being in pain and wondering if I can start a new taper with back/sacral pain going on. If it’s a flare I don’t want to make it worse, and I’ve read on here not to taper if you are having pain.

I’m currently without a rheumatologist. My GP ordered an X-ray which showed osteoarthritis in the sacral joints. She suggested lidocaine patches which help a little bit. Tylenol is minimally effective.

The pain is worse at night and in the mornings, bending from the waist and walking. I’ve also lost weight.

I’m currently on 8 mg. Pred.

I didn’t have this type of pain when originally diagnosed with PMR/GCA.

It is bad enough that I don’t feel like doing anything!

I feel stuck!

[DorsetLady PMRGCAuk volunteer]

Well until you get a definitive answer I would be inclined to stay on 8mg

In fact it might be worth trying an extra 1or 2mg for a few days to see if that makes any difference. If after 5 days it doesn’t make it better, then you can drop back to 8mg.

[Mstiles in reply to DorsetLady]

Thank you Dorset Lady

[Linny3]

I have been having good success with difluonec gel, Seems to be helping the osteoarthritis. Dr. said it is what they prescribe when a patient can't take nsaids.

[Mstiles in reply to Linny3]

Thanks Linny, I’ll try it.

[PMRpro Ambassador in reply to Linny3]

You do still have to be careful with using it when on pred. Diclofenac is still an NSAID and a topical gel is still absorbed into the blood stream through the skin. The risk os lower - it still exists.

[Blossom20 in reply to PMRpro]

What is the risk of using a Nsai with Pred? I thought it was just orally because they both erode the mucous membranes, but it sounds like you're saying it's more than that.

[PMRpro Ambassador in reply to Blossom20]

The effect can still occur because it is on the system - some doctors think it is the being in the blood system that is what creates the adverse effeccts, not the presence of the tablets in the stomach.

[Telian]

I wouldn’t reduce while you‘re in pain and try an increase as DL suggests. If the pain eases then you know your body needs that bit extra.

I’m having to do the same and don’t know what the pain I have is yet. Due to lockdown and shielding I am not keen to go to see anyone either. The increase in Prednisolone has helped my pain which was debilitating.

It’s worth chatting to your GP again as she needs to be updated so you can manage it together. Too often patients don’t want to make a fuss but you have to keep them updated.

Best wishes.

[Mstiles in reply to Telian]

Thanks Teluian for sharing your experience, very helpful.

Just trying to decide what to do next.