New to PMR

[Ahuriri]

I was diagnosed with PMR 4 weeks ago. I started on 15mg Prednisolone and now have reduced to 12.5mg on the advice of my doctor. I don't really know what to expect. I can live my life pretty normally, walks, gardening, but I am not symptom free and in the evenings I get stiff and experience some bursitis type pain in my hips. Is this about par for the course?

[SnazzyD]

Hello there. It might be you are a bit too low in dose but first I’d try slackening off the activity. The steroids are not curing your autoimmune condition, they just stop the resulting inflammation wreaking havoc. Both PMR and Pred make the muscles and ligaments more prone to injury so you have to act like you’re in convalescence and build up slowly. The common reaction to getting relief from PMR pain, plus the false buzz from Pred, is to set about those pesky jobs and finally enjoy a decent walk. Gardening is a usual culprit. So, your Pred is helping you get some quality of life while you play your part and be gentle with yourself and, horror of horrors, act like an ill person. As your condition slows down and the Pred dose drops, you’ll be in a better position to carefully increase physical activity, but try to avoid anything that is repetitive, involves hefting or gripping as these seem to be cause the most complaints.

[PMRpro Ambassador]

Hi and welcome.

Some people are never pain/symptom free - 70% is taken as a good initially. It might have been better to stay at 15mg longer or try a couple of weeks at 20mg But I started at 15mg and had a minor miracle in terms of stiffness andmuscle pain in hours However, the hip and thigh pain which was almost entirely bursitis took a few months to go altogether. I also had foot and hand pain due to tenosynovitis that was slow to go.

I would counsel not doing too much yet or do it in small bites as Snazzy says. Do too much and you will develop DOMS (delayed onset muscle soreness) because your muscles don't tell you that you are doing too much until it is too late. Movement is good but lifting, pulling, hauling in the garden might cause payback. Do the light stuff - get help with the rest.

How are you overnight and first thing in the morning?

[Ahuriri in reply to PMRpro]

I sleep well and mornings are good. Thank you for the advice.