Neck pain?

[RiverKings]

I am a PMR sufferer who weaned off Prednisone 3 weeks ago, after a slow march down from 40 mg. Two weeks ago I awoke with left-sided facial paralysis, diagnosed as unrelated Bell’s palsy. It’s not serious, and goes away in a few months for 85% of its victims. Treatment is high dose Acyclovir (anti-viral) and (what else!) a “burst” of Prednisone (60 mg for 7 days). The past few days I’ve developed extreme pain in my neck below my left ear. Cannot sleep, pain worse at night, unaffected by OTC pain meds. It was so bad this morning that I went for more Prednisone and bingo!, pain went from 9/10 to 1/10 in two hours. I have not read of anyone else having experienced this (I hope you never do) but would like to hear from anyone who has a similar history. Thanks!

[Telian]

Sorry can’t help you RiverKings, as haven’t experienced the same as you, but I would go back to your Rheumie/GP as you need to manage it together - and of course find out what’s going on!

[RiverKings in reply to Telian]

Thank you for your reply. I have spoken to rheumatologist and my family doctor, both of whom suggest trying ten mg a day Prednisone for a week. Oddly enough, I apparently have Bell’s palsy with pain, or I have a PMR flare due to BP. In either case, the Prednisone has knocked out the pain so far so I’m much better! The lack of responses to my post suggests BP and PMR are probably unrelated.

[Telian in reply to RiverKings]

They probably are unrelated - I’m sure someone will be along that might know a little more.

It’s not helpful when doctors don’t know what’s wrong. It’s disappointing for you when you’ve come so far. Do you suffer with arthritis at all?

I have a problem with pain in one arm that is unbearable without 10mg of pred. I had got to 4/3mg prior but had a GCA flare and increased my dose steadily to 10mg. When I tried to reduce the arm pain emerged and doesn’t let me reduce. Waiting to see MSK but not that hopeful of a miracle... It isn’t bilateral so not PMR! I do suffer with arthritis but none this painful (except following surgery for arthritic bone removal).

It’s not the first time I’ve heard of seemingly ‘unrelated’ pain following a burst of pred.

Dx 2014 GCA/PMR.

Best wishes.

[RiverKings in reply to Telian]

Thanks again. No, I have no arthritis issues. This neck pain isn’t bilateral, but it sure responds to steroids.

[Telian in reply to RiverKings]

I knew PMRpro would come along.

Makes sense what she says and does need looking into.

[PMRpro Ambassador]

Because I had time this morning I had a quick trawl on tinterwebs - and found an article where a case with Bell's palsy symptoms was first diagnosed as GCA. Either way - poor blood flow from GCA could cause the same facial symptoms. There is a known link between herpes viruses and Bell's - which is why you are on acyclovir - and there are some who think there is also a link between herpes zoster and GCA. It does seem there is a lack of clarity - but I think I'd like my doctors to have a closer look at the possibility of the PMR having morphed into GCA. Just in case.

[RiverKings in reply to PMRpro]

Good thoughts. I will check out GCA with my rheumatologist. Thank you!