Pred and Thrombosis

[Lauterbach]

Hi, Still relatively new here. Was diagnosed with PMR in August and put on 20mg Pred/day. It was like someone had waved a magic wand – the pain vanished overnight. Have now been tapered down to 10Mg/day and can feel the pain occasionally in my arm muscle – the one that was most affected. But this is perfectly liveable with. Also have a prescription for another month at 10Mg/day

My query is regarding Pred and DVT. I’ve read that Pred can cause DVT, but I don’t know if I’ve Googled myself into a needless scare. It started with me waking to feel that my calf muscles were on the point of cramping up. They didn’t actually cramp up but threatened to. Then I developed a dull ache in my right calf muscle. Not too painful, but needed a paracetamol to get to sleep. It has now morphed into what feels like a normal muscle strain and is a bit painful to walk. The leg is not swollen or inflamed.

Has anyone else experienced this? Grateful for any views

[PMRpro Ambassador]

In all the years I have been on the forums (12+ years and 3 forums) I honestly cannot remember anyone who has had a DVT because of pred. That doesn't mean it doesn't happen and it does - but then, they happen without pred too at our age! The risk is highest in the early days of taking pred and then wanes somewhat in the longer term. Pulmonary embolism is more common than DVT though.

Something that can happen when on pred is that you lose more magnesium than usual through the kidneys and that can lead to cramping - and the first question doctors here in Italy ask if you have muscle cramps is whether you have already tried magneium supplements. They can be as tablets/drinks or spray-on oils or foot baths with Epsom salts.

However, I would check with the GP when you can because a DVT can happen without any symptoms and better safe than sorry is always a good maxim. You say the leg muscle - where? If it is at the bottom of the calf above the heel, it could be an achilles strain or tendonitis - something else that pred can have a hand in.

[Lauterbach in reply to PMRpro]

Many thanks for a prompt reply. The pain at the moment is where the calf muscle thickens out and feels more like a "normal" muscle strain rather than tendonitis. But a trip to the pharmacy seems to be in order for the cramps, which I tend to suffer from anyhow.

[PMRpro Ambassador in reply to Lauterbach]

I think it is a good place to start - rule one thing out at least. Not sure it would warrant the ED/ER without a bit more evidence of a DVT. You feel such a prat when they won't take it seriously!

[membership in reply to PMRpro]

lie down, keep the knee fully extended (straight) and get someone to push the foot up towards your head (fairly gently, but a definite movement at the ankle). If it is DVT you'll hit the roof !! (Homans sign.. not 100% , but a good basic test)

[PMRpro Ambassador in reply to membership]

Not sure you meant to reply to me?

[Lauterbach]

Hi DadCue many thanks for the provided information

[Lauterbach]

Sounds a good idea. And once again thanks for your advice

[Songbird69]

Hello. I had this problem with my calves starting to cramp. Someone suggested to me that it could be a lack of potassium. I started eating potassium rich foods - and drank coconut water. It seemed to solve the problem. Sometimes I get cramp in my toes now - and mostly it is because I had missed a day or two of my bananas! Hope this might help you.

[Lauterbach in reply to Songbird69]

Thanks for sharing your experience

[Viv54]

Hi, yes many times , im on my second round of Pred . Sadly it plays havoc with your muscles and tendons ! I was like you the first time worried it could be DVT, but soon learnt the awful truth about this drug, just another horrible side affect ! i was on a really high dose ,im now down to 5%. with very mild cramps. Hope this helps as always keep an eye on things. This is just my findings while on it.

[madhouse1 in reply to Viv54]

I had cramp at night when on pred, Omeprazole and Alendrolic Acid. One night I forgot to take the Omeprazole and no cramp. When I mentioned this to my locum doctor she halved the Omeprazole dose and I’ve had no more cramp

[Lauterbach in reply to madhouse1]

Many thanks for the info. i'll mention that to the doc - whenever I get to see/talk to him

[Lauterbach in reply to Viv54]

Hi Viv54, judging by people's responses it seems that I may have googled myself into an unnecessary scare. But, as you say, to keep an eye on it

[Noosat]

Two years ago diagnosed with PMR after horrible leg pain. I have tapered to 2mg of prednisone and still feel discomfit occasionally in leg muscles and stiff in the mornings, but certainly bearable, especially when I consider damage that can be done to my eyes with steroids. I have elevated eye pressure. We all seem to have our own particular problems with this disease. Of course my advanced age does not help.

[Lauterbach in reply to Noosat]

Hi Noosat, yes it seems PMR & Pred have a lot to answer for. So I'll keep and eye on the leg muscles and hope it goes no further. But many thanks for your reply

[LIVEORDIEHEREIAM]

Hi Lauterbach! After I had painful leg cramps for a while I heard that putting epsom salt in the shower before you get in gets absorbed in the feet/lower legs. Works for me! I've been cramp-free for a long time now. Every shower, I put a quarter cup in the stoppered tub while the water runs to warm up and forget it.

I'm hoping that's all it is in your case! Good luck!

[Lauterbach in reply to LIVEORDIEHEREIAM]

Many thanks for the info. Will have t give it a go

[PMRpro Ambassador in reply to LIVEORDIEHEREIAM]

Doesn't it just run straight down the drain? Sitting with your feet in a bowl might be more effective ...

[LIVEORDIEHEREIAM in reply to PMRpro]

Not if you stop the drain for a while as I do!

[PMRpro Ambassador in reply to LIVEORDIEHEREIAM]

I'd have about 2 minutes!!! Rather a powerful shower and not a very deep shower base.

[LIVEORDIEHEREIAM in reply to PMRpro]

I guess I am just lucky-- still have the old tub to shower in!

[PMRpro Ambassador in reply to LIVEORDIEHEREIAM]

I have one shower that is over the bath - but I can't get in or out of it safely!!

[LIVEORDIEHEREIAM in reply to PMRpro]

Hmmm. I guess I wasn't aware of how very fortunate I am in that I not only have the ancient tub but I am still able to get in and out of it with a lot of care!

I do see your point. Not all of us have that option with the epsom salt. A foot soak would do just as well. I'm still amazed by our skin's ability to absorb nutrients! Makes me more mindful of what is in contact with mine!

[PMRpro Ambassador in reply to LIVEORDIEHEREIAM]

The bath is only there because the flat was for use for skiiing originally! I'd take it out and have a super shower with room for a chair! The ensuite shower is quite small - big enough to stand under the water though!

[Constance13 in reply to PMRpro]

Glad of that!! Thought for one moment no shower at all.😂

Mind you, we went for weeks without showers when we holidayed on our boat. It's amazing how clean you get with a rough flannel.🤪

[Cosmos22Marigold]

Hi. I get muscle cramps all the time and they are so painfull so I know they are pretty frightening. I am now experiencing them in my ankles quite often but others on the forum had had this so I try not to worry as much now. All this is new to me but the advice you get from reading the forum is so reassuring and helps with the worry of not knowing what is happening to your body. The worrying and stress will only aggravate the pmr. Easy to say I know but all the best and look forward to a good or better 2021.

[Lauterbach in reply to Cosmos22Marigold]

Thanks for sharing your experiences about cramps.

[AdoptMeow in reply to Cosmos22Marigold]

Muscle cramps are often caused by nutrient deficiencies and/or statin drugs for cholesterol. What have you tried to help with the cramps?

[Cosmos22Marigold in reply to AdoptMeow]

I think over the years I have tried most things on the market. Also in the health shops. Spoke to the Dr and pharmacist about it. Put things in the bath water but always get cramps.If I go on walk I can guarantee I will have the cramp that evening and maybe through the night. So painful too.

Do you have good remedy?? I would love to hear if you have. I am not on statins