Reducing steroids

[Dotty4u]

Anyone suffering with groin pain and sore thighs after reducing predisolone

[Seekingasolution]

Yes it’s common with a reduction. Might have to consider a small increase and then slower tapering 1/2 mg every 6 weeks or so.

[Rache]

Sounds like part of my original PMR symptoms. Maybe you’ve reduced too much or too soon? Probably need to know more details to advise

[Sally001]

Yes, I too have been suffering with groin pain for a year and a half along with bursitis in my right hip and sometimes my thighs are sore too. I didn't realize it was caused from tapering prednisone. I have been going from 10 mg to 20 mg for the past year and am presently at 20 mg. Does anyone have any suggestions on how to relieve the groin pain? It is unbearable at times. Thanks.

[PMRpro Ambassador in reply to Sally001]

If it is due to bursitis you need to speak to your doctor about more targeted treatment.

Bursitis that is due to injury or overuse can be improved by physio exercises and rest, avoiding the activities that aggravate it, but when it is part of PMR the underlying cause of the PMR inflammation "feeds" the bursitis inflammation. This

orthoinfo.aaos.org/en/disea...

mentions RA as a cause of bursitis - but, needless to say, not PMR.

I have had a few steroid injections over the years - and they can be miraculous in allowing you to move without pain.

[Sally001 in reply to PMRpro]

Thank you PMRpro, I appreciate your feedback and I will definitely look into this further. Being without pain would be incredible. Is it a Cortisol shot that you had? This morning I upped my pred to 50 mg for 5 days and I will then go back down to 20 mg. I have done this in the past and found that it helps to get rid of the inflammation and pain and hopefully it won't come back for awhile.

[PMRpro Ambassador in reply to Sally001]

Corticosteroid yes, probably depotmedrone. Usually referred to a a cortisone shot.

[Sally001 in reply to PMRpro]

Ah yes, right. I get these mixed up lol. Thank you. I understand the shots hurt but the relief afterward would be worth it.

[PMRpro Ambassador in reply to Sally001]

The last ones I had for trochanteric bursitis the nurse was trying to explain it would hurt - both the rheumy and I were laughing. He was the one who explained that the reason they were being given was really rather worse than the steroid shot!! I get a needling technique at the pain clinic - multiple subcutaneous shots all over my back. Each one burns, excruciating. There are very few patients who won't have them though, some of us ask for them rather than some of the alternatives because despite the pain they are worth it! You can often hear patients using some very colourful language while they are being done!

[Sally001 in reply to PMRpro]

Oh my goodness, that sounds so painful. All over your back, yikes! How long do the shots last and do you get the shots often? I'll bet that there is a lot of colourful language, that sounds so excruciating. I feel for you; I hope your pain eases up. I'm not sure if I'm brave enough to have the shot in my hip; I'll have to ponder this I think. I hope you are feeling better.

[PMRpro Ambassador in reply to Sally001]

The needling is usually 6 to 8 s/c shots, they tend to be monthly or so for a few months and then the effect has consolidated for a longer time. I'm very good - I just laugh while she does them

[Sally001 in reply to PMRpro]

Wow, I am amazed, that is a lot of needles. Good for you for having a positive attitude toward it. I suppose laughing would help to calm the nerves. I am glad to hear that you are good and hopefully you won't need to have shots any time soon. 😊

[PMRpro Ambassador in reply to Sally001]

I meant I laugh rather than swearing. I would LOVE a session asap - but it ain't going to happen ...

[Sally001 in reply to PMRpro]

Haha, yes I can understand that. Good on you.

[Horizon12]

I always suffer from groin and thigh pain when reducing, in fact that's where my PMR pain was worse before diagnosis. My shoulders and arm pain I thought I had just overdone it a bit. 4th flare in 3 years and I had got down to 1mg which was keeping it at bay. Upped to 10mg now on 4, slowly reducing.

[Dotty4u in reply to Horizon12]

Thanks for your input to my question , I am hoping not to haveto go back on steroids I will see how things go, I have only been off them for three weeks.

[PMRpro Ambassador in reply to Dotty4u]

Which is a very common time lapse for people to discover that the PMR is still alive and well but at a very low level that 1mg was plenty to manage and clear out the inflammation each day.

Don't leave it too long: admitting you aren't quite ready yet and staying at 1mg for another few months is far preferable to denying it and letting the dripping tap of inflammation to fill up the bucket until you have to go back to 10mg or even more to get it under control.

[Dotty4u in reply to PMRpro]

Thank-you for your advice, maybe I should go back to 1mg if my inner thigh and groin pain does not ease soon.

[PMRpro Ambassador in reply to Dotty4u]

You might need a few days of a bit more, 5mg maybe, but then you can just drop to 1mg. If it doesn't work - no harm done and discuss it with the doctor.

[Dotty4u in reply to PMRpro]

I have taken 5mg for six days and nearly cleared up my thigh and groin pain, hope to reduce down again soon hopefully, thanks for your info.

[springeramber]

Yes I had inner thigh pain when reducing below 10mg - not too bad and did not last long. I don't have PMR so can't blame that - must be reduction.

[PMRpro Ambassador in reply to springeramber]

What do you have? GCA? PMR-type symptoms can be part of GCA - and often don't appear until the pred dose is being reduced.

[springeramber in reply to PMRpro]

I have GCA - in subclavian arteries and aorta - never had PMR symptoms so I think the thigh pain was due to reduction - the rheumy was trying to blame PMR at one time because ESR was 120+ and he was clutching at straws! Hopefully sorted now on the tocilizumab.

[PMRpro Ambassador in reply to springeramber]

If you have large vessel vasculitis (LVV) then there can be a lot of overlap. This paper explains:

academic.oup.com/rheumatolo...