Slipped in the mud a week ago in my yard and landed on the back of my right shoulder. Currently on 22 mg prednisone. I am seeing my orthopedist about the somewhat severe back and thoracic pain brought on by the fall. I had a full body bone scan taken two days ago and will see the orthopedist again tomorrow for results.
In the meantime it hurts quite a bit. Ibuprofen 800 mg greatly relieves the pain but advice seems to be don’t mix prednisone and ibuprofen. Doctor prescribed Norco 5/325 and said we could try Tramadol but honestly ibuprofen works better for me. Before PMR I was taking 1600-2400 mg daily with no stomach issues for at least the past 20 years. After starting pred I haven’t needed the ibuprofen at all until this latest injury.
So other than potential gastrointestinal issues is there any real problem with taking ibuprofen for muscle injury pain while the prednisone takes care of the PMR chronic inflammation?
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OldGolfer
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PMRpro does advise that she sometimes takes a 800mg dose as a one-off remedy aligned with heat treatment for issues she has with her back.
If you taken ibruprofen in the past in the doses you state without issues then your stomach must be almost bombproof! But personally I wouldn’t want to take so much for too long!
Thanks for the response. Before PMR I was bombproof for a lot of things but I’m not as confident about it anymore! I’m going with the ibuprofen and hot shower for now at least until I get a diagnosis for this current issue.
The general advice is not to take them together because of the risk to your stomach, l used to be on Dicolfenic Acid before l went on Prednisolone & they said l could still take it if/when necessary, this however was stopped due to other reasons.
However, l have had other Anti Inflammatory Meds, mainly Meloxicam but they like to keep a strict eye on your stomach, as Anti Inflams & Pred both can affect your stomach.
So extra yogurt might be helpful & discuss with your Consultant tomorrow as to the best treatment.
I have the Slow Released Meloxicam, once a day & take it well away from Pred with Food but l take Lansoparsole as well!.....
Oh dear, nothing like an accident to change one's life for the worse. Hope you feel better soon. I actually found ice helped my latest misadventure (unusual because usually heat helps). Provided your stomach is well-lined, and you don't take the two meds close together, I should think you'd be okay for a few days. I've continued to take aspirin for headache, even early days on pred when my dose was more significant, and have had no problems. But I don't think I've ever taken it close to my pred dose, not even now with very small pred dose.
I use 800mg as a flooding dose and haven't had problems - but I don't use it regularly. My rheumy approves and a bit back used a high dose NSAID as infusions for back problems for over a week - but made me take a PPI which I don't normally do. It does surprise me when some doctors happily hand out meloxicam and diclofen to take with pred but are iffy about ibuprofen, But in the end effect - is there any point taking painkillers with addictive potential if they don't kill the pain?
I’ve been sorting out a pmr flare as well as a progression of my osteoarthritis. My pharmacist said an occasional minimal dose of ibuprofen was fine on a full stomach. She stressed *occasional*. My rheumatologist increased my prednisone and it settled my pmr flare beautifully. I have taken a single 200mg ibuprofen on two occasions when storms passed through for several days and my arthritis pain was persistent. The occasional low dose is effective for me. I take it hours apart from my prednisone. My rheumatologist has said previously that if I needed ibuprofen more than just occasionally she’d rather try more prednisone.
Oh, and I tripped and fell in my yard recently and ouch. The muscle pain took weeks to resolve. Hot showers, gentle stretching and time settled it.
I have been taking a decreasing dose of ibruprofen for 2 months after being diagnosed with a trapped nerve. I am now on 12 mg pred (was on 10mg when the trapped nerve issue began, upped it to 15mg then have tapered to 12mg over the 2 months) and now on 1x 200 or 400 ibruprofen per day depending on pain levels. To protect my stomach I have been on omeprazole and have been told to keep taking this until I am off the ibuprofen. I am hoping to be off them in another week and if I experience pain then to use paracetamol which is more tummy friendly! Someone mentioned making sure you don’t take the pred and ibruprofen together or on an empty stomach - this was exactly the advice I was given.
I fell recently as well and hurt my chest very badly and shoulder and back. I could not take ibruprofen because I have esophageal issues now which the prednisone has worsened over the last two years. But I find that the French gel Cliptol which allows you to apply it locally really helps. It is warm though so don't start it until the icing for a few days is done. I am also an arnica freak and start every day with that on my most vulnerable parts and I believe strongly it sets the stage. Then if necessary I layer on Cliptol or lidocaine patches.
I would watch taking more than 800 mg orally and you have to count what is in the Cliptol as a dose also so be careful. It not only hurts your stomach but also liver I believe.
Hi. I really don't know about ibuprofen. I can't take it. But, with regard to prednisone, at first it seemed to help my pain. But, then I started to get side effects from it, like swollen legs and face, and bleeding readily. Prednisone is a risky drug to take. I am trying real hard to get off it. I'm down to 5 mg per day, but the bleeding issue will remain with me for the rest of my life, according to the doctors.
They are wrong - once you are off the pred most of the adverse effects do fade with time. And most of them can be avoided or mitigated even while you are on pred.
However - it is your choice, but if you have PMR you will only get off pred without a return of symptoms once the underlying autoimmune disorder has burned out and gone into remission. Over the years I have experienced some of the more unpleasant effects of pred but never anything so bad I am willing to go back to PMR without enough pred.
Weight gain and fluid retention can be helped greatly by dietary approaches: you can reduce the fat deposits by cutting carbs a lot, especially processed carbs and added sugar but also fruit to some extent, and that also cuts salt which cause fluid retention and swelling.
Thank you so much for the information - and the hope!
I trust the folks here on this forum much more than I trust some of the so-called experts. And, I again thank you for giving me hope that the thin skin problem might improve.
Follow up - visit with my orthopedist to discuss results of bone scan taken Friday. Guess I’m not bombproof anymore. Fractured ribs #4,5,6 in the fall. Ibuprofen does help more than the Norco 5/325 so I’ll do a combo ibuprofen and prednisone as needed until resolution of the rib problem in a few weeks. Seem to be having more PMR pain since the fall not in the area of the ribs? Likely the stress trauma is actuating the PMR inflammation and I may need to increase prednisone for a while as well. Have appointment with Rheumy in a few weeks and we’ll go over the options.
Just a word of thanks for all the folks who make this such a great forum. And for those who still think PMR is more tolerable than prednisone side effects - I’m still only a couple of months into this and PMR is awful. I’m very grateful every morning when I can roll over, get out of bed and get dressed without pain. It feels like a miracle every time.
Sorry to hear about the #Ribs, there’s no doubt the fall will have a bigger impact on you.
Most Rheumatologist’s have a Team & a Hotline you can ring for advice, you can always ring that if you’re concerned, to let them know about your fall/ribs.
I think because l’m on Methotrexate I’m more inclined to contact them if l have any issues (been doing this too long!)
Hope things are resolving, it is sad but stress can make the PMR worse, and the world we are living in does not help. Would not recommend tramadol, and if ibuprufen works for you, that is good. NSAIDs do not work for me but the occasional 300mg aspirin does.
Agreed the dietary advice is good, still managed to keep my type 2 diabetes under control by diet, but it can be a struggle. Particularly with Christmas coming on. Good luck
Thanks for the encouragement. Don’t want tramadol myself. Ibuprofen has always worked for me but not Aleve which is one every 12 hours so less chance of stomach problems. Tried it a few days ago and it worked for me finally. More comfortable with less pills. Still starts hurting pretty bad after 12 hours or so but I think I’m functional again while the ribs heal.
My son and his wife told our 4 year old twin granddaughters that grandpa was hurting because I’m getting old. Last night when we went to their house for dinner one of the twins asked about my back and when I said it still hurt a bit she said “that’s okay, you’re an old man”. Love those kids!
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Hope you feel better soon. I actually found ice helped my latest misadventure (unusual because usually heat helps). Provided your stomach is well-lined, and you don't take the two meds close together, I should think you'd be okay for a few days. I've continued to take aspirin for headache, even early days on pred when my dose was more significant, and have had no problems. But I don't think I've ever taken it close to my pred dose, not even now with very small pred dose. 
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