Muscle tenderness

[Cgt1151]

Does anyone experience muscle tenderness after being diagnosed with pmr or gca? I am a 69 year old female. I was diagnosed with pmr in February 2020 and gca, after biopsies, in April 2020. I was prescribed 60 mg of prednisone in April 2020 and am now down to 8 mg. Have had a few relapses, but in general , doing much better than I was a year ago. I have muscle tenderness all over...arms, legs,shoulders and torso. I have severe stiffness whenever I stop moving for any period of time. After responses from forum members, I started splitting the dosage last night. I took 3 mg at 2am and I'm wondering when I should take the 5mg dosage. Should I take it this morning or around 2pm? Not sure if it has made a difference yet. This forum has been a lifesaver. So grateful to everyone who shares their experiences and knowledge.

[PMRpro Ambassador]

I'd take the rest of the dose during the morning - though if I were waking at 2am I;d take the larger part of the dose then and the rest with breakfast. Is the effect not lasting 24 hours? That's the main reason for splitting but the bulk of the antiinflammatory work needs to be done by the 2am dose.

The soreness all over muscles is probably myofascial pain syndrome, the inflammation is in the muscle fascia, the transparent skin you will be familar with from joints of meat or poultry, But I would suggest you have probably reduced just a bit too far - the inflammation is caused by the same inflammatory substances as the PMR in general and it is persisting. More pred might help sort it out properly and then you can start again. I have it and it is definitely better on more pred but I also get more targeted treatment from physio and the pain clinic.

[Cgt1151 in reply to PMRpro]

I am not getting up at 2 am for the day. I just set my alarm to get I to take the prednisone. I usually get up around 6am. So I am thinking of going back to 10mg. I felt better at that dose. Should I take 6mg in the morning when I eat and 4mg at 2am? I actually can feel a difference in the stiffness since taking the 2am dose today. Thanks for your advice

[PMRpro Ambassador in reply to Cgt1151]

I didn't imagine for a moment you were getting up at 2am for the day! But there is no reason at all why you can't take the entire dose then if the effect lasts the full 24 hours for you. The bulk of the work the pred must do is after 4am - the dose already being ready and waiting means the full antiinflammatory effect is utilised and you never get pain and stiffness developing.

[RoadTrip in reply to Cgt1151]

I found moving my whole dose back to 2 am made the pred last longer throughout the day, as before that typically would only last 18 hours.

[DorsetLady PMRGCAuk volunteer]

To have got from 60mg to 8mg in just about a year is very quick (the fact you’ve had a couple of relapses)...my initial view would be your current issues indicate you have gone below the level of Pred you actually need........and to honest no matter what time you take your dose, whether it’s split or not, if it’s not enough, it’s not enough!

[humlies]

I too have muscle tenderness and found this does not change, however or whenever I take the pred. I assume this is part of the whole thing? The backs of my thighs are always tender which make sitting a bit of a bore; however my neck and arms have improved so I am just waiting for further improvements.