Muscle weakness in legs and PMR

[choirsinger1986]

Muscle weakness in top half of both legs occurred 3 days ago and worsening. PMR for a year. Just reduced from 20mg to 17mg over 4 weeks - could this be the cause or is this something part and parcel of long term use of pred ? Tried a two mile walk this morning - muscle weakness occuring sitting, standing, walking or laying down - legs feel like lack of feeling can hardly get up from sitting!

[PMRpro Ambassador]

I think that is something that might merit a call to 111 and speaking to a doctor for advice. Muscle weakness due to pred tends not to be sudden - you do notice them weakening over time - and that sounds more like a nerve problem maybe with it being sudden.

Is your diagnosis of PMR certain? Have you seen a rheumy? They started you on a very high dose for PMR - if you need more than 25mg it should be taken as a red flag - and to have difficulty at 20 to 17mg after a year is also unusual. Do you know what other blood tests were done? Was a CPK ever done (creatine phosphokinase, a muscle enzyme)?

[choirsinger1986 in reply to PMRpro]

Hi.Went A & E could hardly walk and stand from sitting. Predict increased back to 20mg. PMR not confirmed but have all symptoms - esr and prk (I think) tests done. Markers up and down but have had severe pains during this journey where markers were low !

Not happy with level of pred dose and condition no different after 1 year

Rheumy has suggested Amytriptiline and Methotrexate but not keen on both - side effects esp for Metho !

Seeing Rheumy mid Feb - loads of questions planned.

[PMRpro Ambassador in reply to choirsinger1986]

I would be very keen to have more investigations - especially if MORE pred improves things. In the meantime do try Snazzy's suggest of magnesium supplements and more potassium-containing foods. Maybe your GP would do blood tests for electrolytes.

[choirsinger1986 in reply to PMRpro]

Thanks will place in my list of questions for my mid Feb appointment.Not convinced at all with taking Mtx.

[PMRpro Ambassador in reply to choirsinger1986]

It would be the right action if it turns out to be certain other things rather than PMR. But that is what I am less than convinced about. Some people do really well with mtx - you have to try to find out though.

[SnazzyD]

Hmm, not sure Pred or PMR can be blamed with enough certainty to put it down to them. Dose still way too high to blame poor adrenal function. Sounds a bit extreme too and needs a call to a doc. Worth considering in the meantime if you are getting enough magnesium (I had to supplement) and high potassium foods.

[PMRCanada]

Have you exercised (walking or hiking), or overdid it physically.... this could lead to DOMS. Pred withdrawal symptoms also can cause weakness and body aches, and a taper of 3mgs seems quite quick.

Hopefully you can explore further with your doctor and at the very least rule some things out and get some much needed relief. It’s horrible to be in pain AND have limited mobility...especially if you are used to being active. Others on here have made other suggestions that may warrant follow up. Advocate for your health...if you’re not comfortable with Metho or other medication they offer, you can suggest they confirm a diagnosis prior to adding medications. AI conditions respond differently to different medications, as do we even with the same condition.

[Alchemy8 in reply to PMRCanada]

DOMS?

[PMRpro Ambassador in reply to Alchemy8]

Delayed Onset Muscle Soreness - the sore muscles that appear the day after overdoing a physical activity

[choirsinger1986 in reply to Alchemy8]

Did a bit of exercise on a bike and a short walk. However it was not soreness that resulted it was intermittent lack of feeling/numbness to the muscles immediately above the knees. Used to play 5 a side footy and never had these symptoms.

[PMRCanada]

Delayed Onset Muscle Soreness:Delayed onset muscle soreness (DOMS) is the pain and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise. The soreness is felt most strongly 24 to 72 hours after the exercise.

I experienced this a few times, especially in the beginning when first on pred and finally felt like I could do all the things I was previously restricted from. I paid for it afterwards.

[choirsinger1986 in reply to PMRCanada]

Been on pred for a year and carried out a variety of exercises without any symptoms of DOMS