Hi all, I was diagnosed with PMR in June to his year after originally thinking I had massively strained my shoulders and neck. Could not sleep due to discomfort in neck, shoulders and upper back, some hip discomfort. Tried every amount of pillows and pain killers, Tramadol helped however eventually diagnosed with PMR and placed on steroids at 15mg and after a week the discomfort improved by over 75 percent. I have now reduced to 8mg and all the way through I can still feel the shoulders are not right specially lifting arms above shoulders. I still try to to train with light weights at home 3 times a week for 30mins or so as I used to attend gym. My capacity severely restricted to what I used to lift. However I have a couple if guitars which I enjoy playing around on and I am sure to his aggravates my shoulders more than anything? Has anyone else found playing a guitar adversely effects Thier shoulder areas after playing, I am only picking up the guitar for about 30 mins or so ? Before to he prednisolone I found I was unable to play due to pain and discomfort
I am 61
Thanks Mike B
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Hi Mike, I’m by no means an expert as I am fairly new to having been treated for PMR also. I am referring to your shoulders, and wondering if you have had any investigations as it is quite common to develop bursitis during / onset of PMR. I have bursitis in both of mine, was incredibly painful early on but both having eased up significantly with prednisalone and with time. An ultra sound scan will identify any such issues and then your GP will advise in terms of physio or steroid injections. Best wishes, C.
C Thank you for your response, I believe bursitis is a a common side effect of PMR and I have had historic problems with shoulders from years of weight training, however has xrays prior to PMR diagnosis and shoulders are not arthritic. I was under the impression that the Pred would have the same effect as a steroid injection on any bursitis however May well be wrong, as you say it would be worth contacting GP for ultra scan but in these covid days I feel I could be in for a long wait. Regards Mike
I have had bursitis in both knees for the past 9 months, rhuemy said it will go once the PMR clears up and not to kneel down. Kneel down! a, it would be too painful and b. I'd have difficulty getting up. It's sounds as if I've got to put up with it for the duration. 2.5 years into my journey, on 5.5 pred.
Not prepared to try a steroid injection? Oral pred often doesn't get to high enough a level to do much around certain parts of joints because the blood supply is not good enough.
You won't want to hear this but you are trying to get back to 'normal' too quickly. Lifting light weights is good for your bones but you are still at an early stage in your PMR journey. Your activities need to be rotated to avoid fatiguing the same set of muscles. From my own experience a good physiotherapist will assess you and give you graded exercises to improve your range of motion and fight inflammation. You most definitely shouldn't be trying to push through pain. If it hurts or is uncomfortable-stop!
I can understand your keenness to resume the activities that made you feel good pre-PMR but that can't be hurried and will push you back.
You also shouldn't be reducing your Prednisolone dose while you're still experiencing pain. People here will be advising on tapering very soon.
If you are currently at 10mg - your reductions now should slow to 1mg per month maximum. You aren't reducing relentlessly to zero but to find the lowest dose that gives the same result as the starting dose did - you shouldn't feel worse at the end of a reduction step than you did at the beginning and any increase in pain is a warning to slow down. No reduction step should be more than 10% of the current dose - especially as you approach lower doses.
I'd say starting with 5 mins or so would possibly be an answer! You must learn to walk before you can run (so to speak!). Once you can do 5 mins without payback next day (a rest day) you can add a couple of minutes at a time, always assessing that it is still OK on alternate days. It sounds slow but it really doesn't take long to build up the time. And that applies to everything - not just the guitar.
PMR is also often accompanied by myofascial pain syndrome and that can affect the shoulder and neck muscles badly - spasmed muscles will protest loudly if you ask them to do things they perceive as a threat and to be causing them pain so they tighten to protect themselves.
Being on pred doesn't cure anything, it removes the inflammation that causes the pain and other symptoms. The actual underlying autoimmune disorder continues in the background, leaving muscles and soft tissues vulnerable and intolerant of acute exercise. You have to "train" again - and that means starting from a very low level, not the level you were at pre-PMR and pred. You will get there - though probably not to the same level, most athletes reckon on a maximum of 70-80% of their previous level as long as PMR is active. Later is another situation altogether and can't be forecast.
Thanks for advice as others said probably trying to normalise too quickly, would you say it was worth speaking to GP re bursitis or as you say it's just part and parcel of condition and carry on.
It might be but usually GPs are not very proactive in such matters at the best of times and at present - can you even speak to one! I didn't have shoulder symptoms due to bursitis - only in my hips and that took a few months to go once I was on pred. The myofascial pain syndrome part is ongoing because of other factors. IF you can find a good one, a physio may be able to advise but normal physiotherapy doesn't really help in PMR, the therapist must be very aware of the limitations. Muscles that are still tight/spasmed and painful can't be "trained" - they just respond by tightening even more. The muscle spasm may be helped by heat and stretching and I found Bowen therapy very good.
Shoulders are a very big part of PMR for many of us & had Shoulder Issues leading up to a PMR Diagnosis.
Keeping your shoulders moving is good but weights l’m not so sure about, remember our muscles are very, very inflamed.
Also how quickly have you reduced from 15mg to 8mg? You may well have overshot the dose needed to keep symptoms in check.
My Symptoms were certainly aggravated by my Job despite wearing a Headset for answering the phone & moving/adjusting my Computer Monitor so l didn’t have to look up/down it to the right/left, just straight ahead!....
I was prescribed Amitriptyline long before PMR for a different shoulder issue & have been on them since before PMR was diagnosed.
It works by relaxing the muscles overnight & many people get relief from this.
As PMRpro says you have to ‘rest’ the following day after you do something particularly that involves a muscle group that is easily aggravated.
It takes some time to adjust & wish you lots of luck.
I was diagnosed in Jan 2018 and experienced all the usual terrible pain, shoulders, hips, knees, hands, just all of it. I stopped all motion that exhausted my muscles. The only thing I could do without pain was strum the guitar. I play a GS Mini and not a dread.
The advice to be gentle with your muscles and to taper your prednisone dose very slowly is excellent. There is a great amount of wisdom on this site.
The fact that Tramadol helped could mean that you have something other than PMR too such as bursitis, as Tramadol normally does not touch PMR. You could try a painkiller as well as pred to see if it improves things.
I only used Tramadol prior to PMR diagnosis it was the only thing that allowed me some sleep as it also made me drowsy. I have not taken at all since on steroids, the Pred made a massive difference after 3 or 4 days and allowed me to sleep and my pain and discomfort improved by approx 75 percent after a week.
I was saying if you tried say Tramadol to see if things improved as it may be something on top of PMR as well. If it doesn’t help then it is just PMR that is the problem.
Snap , I wasn’t playing guitar for long a beginner really about 15 months and my left shoulder and left clavicle started giving loads of trouble , surgeon told me I need surgery now on both ends of my clavicle , so I stopped playing guitar and in 6 weeks the pain has almost gone in the shoulder clavicle still a bit sore , I’m a lefty by the way my guitar teacher thinks it’s the strumming that set it off, just picking seems to be ok , I don’t think it’s the weight of the guitar more the constant movement of my shoulder. I’m 60 by the way, so virtually same age .
Gaz, thats Interesting I am right handed and getting most pain in my right shoulder it seems worse if I play/practise for longer. I am only beginner/intermediate however find I can play for about 5 mins its ok any longer and also feel in my clavicle and constant ache/pain, so not strumming shoulder. I am leaving alone all weekend to see if it settles down, I still get the PMR shoulder stiffness feeling across both shoulders but manageable .
I’m not playing at all at the moment which is frustrating as really thought I was starting to see improvements in my ability . Who would have thought PMR could even interfere with playing a musical instrument , so frustrating.
Any repetitive or sustained action is poison in PMR - even holding a phone to your ear can be felt in the biceps. It is one of the problems experienced with patients who end up with a poorly-informed physiotherapist.
PMR pro I do not have a physiotherapist and have not been referred to one since diagnosis, all I have seen is a GP and had blood test. Is it normal to be referred to a physio?
Not for PMR, not really, but often the diagnosis is wrong, thinking it is "frozen shoulder" or some other mechanical problem. Or a belief that the stiffness would improve with exercise.
Hi Mike, it's not just a guitar thing. At the moment I am having strong aches/pain fairly continuously in my left shoulder and left side of neck with the right side side joining the fun on occasions during the day. I don't, as far as I know, do any repetitive actions which would bring it on. I walk the dogs but that causes no strain. Will talk to doc a week tomorrow, but seriously considering upping my present 13mg. Regarding pain killers I do take Co-Codamol for my OA but they have no effect on this, which they won't if its PMR. Peter
You'd be surprised how much strain walking the dogs might be causing! All the small things add up - and while they may have been small pre-PMR you have a new normal now. I know, it's boring - but it is a reality.
Sadly, logic tells me that as usual you are quite correct, there isn't anything else and I have not been wiling to admit it to myself, just have to decide what to do about it. 😭
I just had to increase my Pred dose for a couple of days as I too was getting left sided neck and shoulder pain (it’s always here when I flare) I think it was caused by my heavy shoulder bag. I have downsized but it’s still heavy and although I try hard not to put it on my shoulder sometimes I have to.Goodluck to you.
Your doze of pred is to low I couldn’t lift my arms last week with shoulder pain sheer agony like two frozen shoulders . Remember steroid is your pain killer . Hope your outa pain soon . I’m 54 year old so struggle to believe I can’t do everything I want to but I’m learning . I’m year and eight month in the journey and this group is the best advice going they suffer same as us . Good luck 🤞
I'm five years older than you and was diagnosed with PMR three years ago.
I'm now down to 3mgs but have also developed Afib which does restrict me somewhat.
Luckily my activities are mostly sedentary - I'm an avid reader and musician.
I do own a couple of dreadnought guitars but was finding the stretch was causing pain in my shoulder.
My son who is a professional musician suggested investing in a Taylor GS mini or one of the Taylor academy models which have an armrest built into the guitar.
I picked a GS up on eBay and it sorted the problem.
Another cheaper alternative would be something like the Yamaha FS series - they are a lot easier and smaller to play than the normal FG's and very good value.
PMRpro is right about dogs.
I find I can't walk my two golden retrievers on a lead without them jolting. I now just stick them in the back of the car and drive them where they can safely run off the lead.
After my own experience with trying to taper too fast I think it sounds like you still have a lot of inflammation in your shoulders that needs to be cleared. Would you consider going back up to 15mg for a week and coming more slowly down? Half a mg a drop. You really don’t want a major flair - that's what I ended up having. Best wishes.
Hi Mike, your story has similarities with mine . I was a Carpenter and 40 years of lifting sheets of 3/4 ply and plasterboard took a heavy toll on my shoulders. I am supposed to have 4 tendons to each shoulder and now I am down to approx. 3 1/2 tendons altogether. LOL.
My Polymyalgia caused my retirement at 64 years of age when I was aching all over as if I had the ‘flu’ and the Prednisolone swiftly caused a huge improvement. But the trouble is that although it keeps it in check so that you can live a normal life, 6 1/4 years later the problem is still there.
Anyway, moving on. I started playing the guitar when I retired and I can’t see any likelihood of it troubling you shoulders, unless your copying Hendrix’s techniques as well as his songs, and playing it with your teeth and behind your back!
I alway play sitting down and occasionally get pains in my left thumb (I am right-handed) after an extended session. Not being a Gym or weights man at all (I got enough exercise at work) I would leave out the heavy lifting and get your tendons checked out.
My arms are good for working at a bench or table but after 15 minutes working over my head I have to stop. The consultant started me on 20mg of Methotraxate in 2017 but I can’t give up the Prednisolone.
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