Ibuprofen?

[LemonZest11]

Is it true that ibuprofen doesn’t help with PMR pain?

[Rugger]

People do say that 'normal' painkillers don't help and pred is the only thing that does. Also, we shouldn't take non-steroidal anti-inflammatory drugs like Ibuprofen when we're on pred because of the effect on our stomach, I believe.

[LemonZest11 in reply to Rugger]

I have been thinking about you, and wondering how you are. When I had what I thought was a flare, my rheumatologist was annoyed that I upped the pred. I am back on track, but I have been taking 1 only ibuprofen occasionally and I find that it helps. She may be right.

[DorsetLady PMRGCAuk volunteer]

It MAY help with the pain, but it’s not recommended to take a NSAID alongside Pred - not good for stomach in particular.

[LemonZest11 in reply to DorsetLady]

That is what I thought, I think I have read that many times on here. My Rheumatologist as asked me to take anti inflammatories rather than more pred as I taper lower. I have found that they actually help. I’m wondering if it is the PMR or something else. I never take ibuprofen on an empty stomach, and only a couple, one at a time, a day.

[PMRpro Ambassador in reply to LemonZest11]

They are mentioned in earlier articles about managing PMR, but the 2015 Recommendations discourage the use of NSAIDs. Most people find they barely take the edge of PMR pain and regular use of the sort that would probably help is associated with a pretty high risk of gastric bleeding and other long term adverse effects. I think most people would say that if ibuprofen does help it is something other than the PMR. OTOH, I find ibuprofen deals with an acute flare of the low back pain I get with the myofascial pain syndrome that is definitely a part of my PMR.

One suspicion that has to be raised if NSAIDs help what is thought to be PMR pain in someone who isn't typical is whether the PMR diagnosis is correct. But if TCZ is helping you reduce that makes PMR more likely.

However - for half of GCA patients TCZ doesn't get them off pred altogether. This is because there are 2 other mechanisms for the inflammation on which TCZ has no impact. But I don't think they know if the same applies in PMR.

[LemonZest11 in reply to PMRpro]

Thanks, I have no idea what is causing the ache around the muscles of my upper arms but taking one ibuprofen seems to help. I will be cautious.

[PMRpro Ambassador in reply to LemonZest11]

I had a physio appointment last week and having told her I had upper arm and shoulder discomfort in the morning after sleeping on my left side - I know I shouldn't but the body doesn't remember when it is asleep. The "pain" is where the attachments to the shoulder blade are and down the upper half of the upper arm. I also have a pacemaker which doesn't seem to help in that respect!!She spent well over half an hour working on the shoulder/arm - she said the muscles were hard and knotty. It was rather INTERESTING - downright painful in places and next morning I had a faint bruise at one of the worst bits - but the relief was amazing. That pain had improved with ibuprofen too - I think it really helps in myofascial pain syndrome.

[LemonZest11 in reply to PMRpro]

Yes! This sounds very familiar. The physio has hurt me also, but the next day it is so much better. She is very cautious about stirring anything up and worries that she will have an impact on my PMR, but this upper arm muscular thing feels different, AND, it is eased with just one ibuprofen. I have also taken paracetamol for this and it helps, but I’m nervous about liver damage. Does paracetamol work for this ache you have in your shoulders/upper arm?

[PMRpro Ambassador in reply to LemonZest11]

Never tried it because paracetamol usually does zilch for me. Unless it is administered as an infusion - THEN it is a wonder drug!!!!

[LemonZest11 in reply to PMRpro]

Thanks for always responding to questions and salving concerns. I hope you know how much your support to us is appreciated, and your opinions/advice is respected. You must be a pretty special human to offer your time so generously and with such wise words and researched information. I hope you have someone to whom you can turn. Thank you.

[LemonZest11]

Rather than increase the pred, my rheumatologist has asked me to take anti inflammatories while I am tapering, using the “assistance” of biologics. I have found that they help. The stomach thing is a real threat, but I never take them on an empty stomach.

[Skymollie]

Have you tried the extra strength Tylenol arthritis? I used to take one plus an Ibuprofen until I got Dr to prescribe celebrex which is easier on stomach. I never took Pred but Depo Medrol. But they had prescribed methotrexate with these pain meds if that helps. The Tylenol is acetaminaphen. Those two pain pills saved me for months.

[LemonZest11 in reply to Skymollie]

We call that paracetamol in Australia. It is very hard on the liver. I do have celebrex but I didn’t realise that it was less hard on the stomach. I think the secret is to line the stomach. It’s just really great to hear that people are getting some relief from PRM from other than prednisolone.

[PMRpro Ambassador in reply to LemonZest11]

There are plenty who would dispute the claims made about celebrex! And being "better" doesn't mean it doesn't have the risk. It also has cardiovascular problems associated with it.

hss.edu/conditions_guidelin....

[LemonZest11]

Well I have been taking TCZ for six months and it has definitely helped with the tapering. But just recently, on 4mgs of pred, I had the old shoulder pain return, however it has not really been shoulder but more biceps. 4mgs has, in the past, been my danger zone so I sought some advice here and took it, up the pred by 5 for a few days and then return to just above where I was. Coincidentally, I had a rheumatologist appt around the same time and she was not impressed. She asked me to try taking anti inflammatory meds, rather than increase the pred ... so here I am. ibuprofen seems to help but the advice is all about the impact on stomach. I take it with food always, so hopefully that should prevent any stomach probs. How are you?

[piglette]

Before I was diagnosed with PMR, nothing helped with the pain including Tramadol. Thank goodness for pred.

[Coffeebeans]

Whilst waiting for my GP to take me seriously I was taking naproxen and strong co-codamol. It took a small edge off the pain and that was it. I was taking the maximum amount allowed and that really couldn't continue at that level.

I am glad in a way I took these because the PMR diagnosis isn't always straightforward. It's useful to know if NSAIDS worked for you or not.

CB

[LemonZest11]

Glad to hear that you are able to manage without predsisolone. It sounds as though you are doing well. Thanks for the help.

[Amkoffee]

I can't take pred any longer and I can't take ibuprofen either. So I'm taking aspirin which is just enough to take the edge off. But both ibuprofen and aspirin can reek havoc on your stomach.

[SusanEleven]

My rheumatologist prefers that I increase prednisone a little rather than add ibuprofen. It can be tricky to know what to do when you have multiple sources of pain. I take one ibuprofen on a full stomach (per the pharmacist) on rare occasions when it’s clear to me that my osteoarthritis is the culprit.

My body has never responded to Tylenol/paracetamol. It does zero for me. I relied on aspirin in my younger days which worked well. Our body responses are so individual.

[LemonZest11 in reply to SusanEleven]

Very true. Thanks for your thoughts.