PMR cause pleurisy?

[Jesse-Cat]

Can PMR cause pleurisy or is there a link? Or a link with Prednisolone? I think I may have it as I have sharp pains breathing in which is worse when cough and sneeze and now have developed dry cough too. Will try and see GP tomorrow, with open mind, but curious if there is a link. Does anyone know?

[PMRpro Ambassador]

Where is the pain? Could it be costochondritis? I don't know of any link for pleurisy and PMR.

[Jesse-Cat in reply to PMRpro]

It used to be more central and seemed very muscular. That has subsided and now it is more a stabbing pain centrally in the oec, especially the left one. Pain when breathing in deeply and when lying on my left side. And this dry cough has started since end last week. I read online a link between pleurisy and autoimmune disease but mentioned is rheumatica arthritis

[piglette in reply to Jesse-Cat]

Have you read up about costochondritis? It just seems several people have it including myself, it just came out of nowhere. It even hurt to breath.

[SheffieldJane in reply to piglette]

I have had costochondritis occasionally over the 5 year period of PMR/GCA sometimes accompanied by an extremely irritating dry cough. Having said this, I would be wondering about a COVID Test and if negative wanting an XRay. The link with pleurisy and a suppressed immunity may mean that an ordinary chest infections might be more likely to progress to pleurisy. You need to involve your GP. Are you on any other meds with this in the side effects? Some of them are appalling.

[Jesse-Cat in reply to SheffieldJane]

Think you and PMRpro are right, having looked it up. When I checked symptoms first time, pleurisy came up. However costochondritis makes more sense as it seems muscular, as if sprained. I don't have other medication. What seems to me that now I'm tapering down, I have lots more muscular issues, like tendinitis. I dont think it is the original PMR but muscle issues due to under use and weakening. Would like to have physiotherapy and am waiting for appointment. Think need to go private as have been waiting since early October.

[PMRpro Ambassador in reply to Jesse-Cat]

Have you told your GP? Chest pain of any sort should be taken seriously and not self-diagnosed through Dr Google!

[Jesse-Cat in reply to PMRpro]

Pain is located around the chest and is muscular. It has been around for some time and is slightly reducing. I am sure it is not serious or life threatening, just annoying and limiting like the other aches and pains

[PMRnewbie2017]

I get intermittent costochondritis and my tendons are also sore and very susceptible to injury. I can pull a muscle hanging washing on the washing line!!

[Jesse-Cat in reply to PMRnewbie2017]

What are you doing to reduce the tendinitis? Exercise?

[PMRnewbie2017 in reply to Jesse-Cat]

It's hard to stop it happening without wrapping myself in cotton wool and doing nothing. I treat it with hot/cold and anti inflammatories and kinesiology tape strapping and avoid over using the agfected part.Healing typically takes about 6 months. It's very frustrating.

[Alebeau]

I suffered those same chest pains throughout my first year with PMR. Doctors checked my heart and lungs and found no problems.

I did physio afterwards and they thought it could be a rib misalignment causing the breathing pains. These pains were terrible and at times I didn't even have to breathe that deeply. Terrible.

Thankfully after doing routine stretching as advised by the physiotherapist my chest pains subsided and it feels great to breathe again freely. It could well have we been a PMR effect along with poor posture. That first year with PMR did not allow me to exercise due to the pains from inflammation.

Exercise is very important for we.

Good luck.

[Jesse-Cat in reply to Alebeau]

Thanks. I used to run and weight lift and other exercise. It has all stopped since end 2018. When walking, after 20 or 25 minutes various muscles in my left leg start playing up. I am thoroughly fed up with this sedentary lifestyle with the tinnitus on top.

[Alebeau in reply to Jesse-Cat]

Yes it is no fun when pain stops you from doing things. The prednisone has at least allowed me to exercise again on a semi-regular basis as there are still days when exercise is just too painful so I wait for the next good day. My sed rate is going up again - 17 - and have had more pain lately - I hope it subsides on it's own as I do not want to increase the dose unless absolutely necessary - hope to get the dose to 5 mg some day 😀

[PMRpro Ambassador in reply to Alebeau]

I suspect it IS necessary. Your symptoms are obviously increasing- and your sed rate rising, albeit it may be slowly and it is still in normal range shows there is increasing inflammation in your body. The dripping tap is slowly filling the bucket - ignore that and you will end up where you started when you went onto pred in the first place. Act quickly and you may get away with a few days of a higher dose and dropping back to your previous dose, not the current one, which may be enough. Leave it - and you will be back where you started.

[Alebeau in reply to PMRpro]

I hate to go down that new road. I am hoping this is a transition period to allow my immune system to start functioning again on it's own. Does that make any sense or am I dead wrong?I really appreciate your advice and am anxious to see your reply.

Thanks

[PMRpro Ambassador in reply to Alebeau]

Staying where you are would maybe help with the adrenal side of things - but at the expense of managing the PMR which for me would be the priority. Pred only manages the inflammation - it has cured nothing. Nothing cures PMR except time - for the majority of patients the underlying autoimmmune disorder burns out and goes into remission but until that happens you need the right dose of pred to manage the inflammation. If you go too low, even very slightly too low, there will be a small amount of inflammation left over each day and, like a dripping tap fills a bucket sooner or later, the inflammation builds up until it is enough to cause symptoms again and, eventually, take you back to where you were at the start.

The adrenal function bit isn't going to make your immune system work any better - and the effect of constant pain is a stress on the body as well which won't help the immune system either. Adrenal function is something to think about once the PMR allows you to get to 5mg or so - then you have 2 factors to consider. For the moment though - worry about the PMR and the pain.

[Alebeau in reply to PMRpro]

Thanks, I guess I mistakenly made the conclusion that if the adrenal gland ould kick in it would see how reverse the PMR.

So I have been at 9 mg going on month 3.

What regime would be most successful to reduce ESR (and associated pain) and then get back to the 9 mark as quickly as possible?

I reduce by .5 mg at a time

Thanks

[PMRpro Ambassador in reply to Alebeau]

What is usually recommended by good rheumies (and so us) is adding 5mg to the dose where you flared for up to a week and then drop straight back to the dose ABOVE the flare point. So 14mg for 5-7 days, then 10mg and reduce slowly from there. You might get to 9mg but it seems to be slightly too low - if you can manage 1/2mg at a time you may manage it.

[Alebeau in reply to PMRpro]

Will try this a let you know how it goesThanks