GCA pain and Paracetamol

[ChinaWuntoo]

Have had PMR for eleven months. Now slow tapering from 9mg to 8mg and going quite well. Just to mention, also: I have been tense for some time and would not be surprised if I have anxiety pain.

Yesterday I developed a new type of headache. Back of the neck on left side, radiates up to scalp. I've had tension headaches before in the back of my neck and it feels like that. BUT the top of my head is very painful to the touch and also, like the neck pain, it is irregularly pulsating pain (i.e. not in time with my pulse) . When I say severe, I don't mean sensitive, I mean real pain when it is touched. Sometimes the top of the head pain radiates to my ear. All on the left side.

My question is: if this is GCA (I have no other symptoms) would it be relieved by paracetamol? I do seem to get relief, although the pain returns after a time.

[DorsetLady PMRGCAuk volunteer]

Paracetamol might take the edge off for a short while. What exactly do you mean by “pain returns after a time” ? - minutes, hours, days?

Ears can be affected by GCA, so I think you may have to consider it may be that - so further monitoring, then advice from medical team in required.

[SnazzyD]

A few more details would help as DL says but medical opinion may well need to be sought sooner rather than later. Could be GCA, could be shingles (can be excruciating), could be something as simple as sternokleidomastoid muscle tension that can mimic GCA, could be something else. Any change of eyesight needs a trip to A&E. I found that Paracetamol did not help my GCA pain and it just escalated.

[ChinaWuntoo in reply to SnazzyD]

Thanks to you both.

I had these pains on and off during the morning and afternoon yesterday with only very short periods between. At times it got very worrying and I considered 111. I took paracetamol when I went to bed and slept until 4.30am when I was woken with severe headache. This morning was the same as yesterday but this afternoon was almost free of pain. I had taken paracetamol at lunch time. I also had dealt with some of my tension-inducing challenges (including getting a story book finished, printed and distributed to the great-granddaughter). Then it returned late this afternoon. Again paracetamol seems to have helped a bit. Hope that answers the question.

Yesterday I got very hot in the face - this sometimes means my blood pressure is up - and it was but had gone down when checked a couple of hours later. This morning it was up again - still within safe levels but high for me (I keep regular checks).

Is it my imagination (!) or do I feel a sort of numbness on my left cheek? Also wonder about slight earache. I certainly have had temporal pain at times since diagnosis of PMR but not at present - this is what has confused me.

I know that I need to run to A&E if I have vision problems - I check morning and evening by reading the books on the shelves across the room!

I've just read the Abdul Qayyum Rana et al article on a differential diagnosis of GCA and tension type headache and it seems to fit my situation.

PS I had shingles many years ago - this is not like that pain.

[PMRpro Ambassador]

I agree with the others - I think you need to speak to the GP. I know you have a rather useless specialist ...

[ChinaWuntoo in reply to PMRpro]

Thank you. Seems the right thing to do.

I'm thinking that with the GP (I have to convince the receptionist that I need to speak to him! Urgghh) is to say I suspect GCA, then give HIM the symptoms and see what he says - and be ready to make my case for a speedy referral to a rheumy, hopefully not the one I sacked but who won't lie down!

I'll come back with any news.

Thanks again to all.

[SheffieldJane in reply to ChinaWuntoo]

There is always the emergency room. If your collection of symptoms carry on, I think it warrants the trip and disruption.

[ChinaWuntoo in reply to SheffieldJane]

Thank you.

It wasn't my imagination - have had earache during the night - possibly the jaw directly in front of ear. Everything else continuing.

(Legs, arms, speach all ok so not a stroke.)

Back later after speaking with GP or ANO

[ChinaWuntoo in reply to ChinaWuntoo]

Just a thought: does anyone know of a London hospital that has someone who knows about PMR/GCA. I have some recollection that Kings and Imperial may have a fast track GCA. , perhaps Moorfields? I have no idea of what the GP might have at his fingertips.

[PMRpro Ambassador in reply to ChinaWuntoo]

You have asked that before. Nowhere in central London has a fast-track set-up as far as we know. Someone did say they had a good consultant at one hospital but I can't remember which.

[ChinaWuntoo]

I wasn't just wondering about fast track but just specialists in PMR/GCA. I think you may be thinking of Chertsey which is a bit far for me.

I have now spoken to a GP and things are moving - going to A&E locally who will probably consult with rheumatologist.

Back later.

Thanks again.

[PMRpro Ambassador in reply to ChinaWuntoo]

No - I wasn't thinking of Rod, I know you think that is too far. It was a central London hospital.

[ChinaWuntoo]

Not GCA, a relief!

GP (a young locum) agreed that my symptoms could indicate GCA so sent me to A&E where (another youngish) doctor did lots of tests and confirmed negative.

It's good to meet doctors who obviously know what PMR and GCA mean!