One more question about flares

[Darcy2000]

I am holding off calling my Rheumy because I am pretty sure he will bump up my Prednisone..don’t want to

Continue with this pain in my left foot ( ongoing for several months) but much worse now and my right knee ..stiff and

Painful.Just came on when I decreased my Pred to 8 mg . My question is does PMR feel tender to the touch ...still hoping it is something other than a PMR flare and how long do you withstand it before you increase your Prednisone

[TheMoaningViolet]

Hi Darcy2000, I am not an expert on flares, but it does sound like something else. Is the pain you are feeling now similar to the pain you had with PMR before you started the treatment? The fact that it is happening on one side (left foot, but right knee) may mean that it's not PMR. If you have any pain separate from PRM, it is likely to get worse as you reduce the steroids. Perhaps you need to have your foot and your knee looked at so that this does not start to interfere with your tapering.

[HeronNS]

I've had some of that painful to the touch pain, in my shoulder, and I think it's something else, not PMR. My physiotherapist did some stuff mostly involving my neck (for a foot it would be another part of the spine) as well as the shoulder and it was much better for a while. Also I find it responds quite nicely to other painkillers although I only use them when desperate. It could be osteoarthritis, another disease which can flare and then die down again, and I do have quite severe OA in my neck. The shoulder pain is at least partly referred from a nerve in the cervical spine. Have not asked a doctor about this. Possibly something similar is happening to your afflicted lower limb.

That being said, I did have increased PMR pain a while ago and when I increased my pred dose the shoulder felt a lot better - but OA pain does respond to pred. I am currently trying to keep PMR separate from OA pain and treat PMR only when it comes to pred. I think pred is fundamentally not very good for me so would like my dose to be kept as low as possible. (Currently at 6 or 6.5, after several years around 2, and then a major flare earlier this year and ongoing.)

[PMRpro Ambassador]

Is what tender to the touch? Muscles?. The knee? The foot? All over? A particular place? All the time or just after activity? Is it hot as well? Does it respond to ordinary painkillers - and is there a difference between NSAIDs and something like paracetamol or cocodamol?

It doesn't really sound like a PMR flare, not really even enough, left foot, right knee. But I think you need to talk to the rheumy - making sure you have the answers to the sort of questions I've asked ready.

If it is a PMR flare and you don't increase the pred you are at risk of it just building up until you are back where you have been before and needing even more pred - butif it isn't, then it needs to be investigated and the right treatment found. If it is PMR, the longer you leave it, the harder getting it under control will be. PMR always wins.

[Darcy2000 in reply to PMRpro]

Thanks again... woke up today with significant reduction in pain in the knee and foot somewhat improved. For the time being I will stay the course My Rheumy appt is in 2 weeks .. not sure what his take on me playing with Pred dose . Today I would not feel justified in increasing yesterday I would ... strange disease

[PMRpro Ambassador in reply to Darcy2000]

Which really suggests it is something else.

[SandyBoots]

Hi Darcy, It doesn't sound like PMR if it is one foot. Do you have any radiating pain, down your leg to your foot? I have sciatica (on one side) and it is caused by osteoarthritis in the lumbar region of my back. the pain radiates down my leg, knee and into my foot. On my way to the physical therapist today about it. I am quite sure it is not related to my PMR but is associated with the arthritis. I also have arthritis in my foot (what a mess i am!) and have found that i will sometimes have knee pain as a result of compensating for the pain in my foot. On another note, I am a big believer in really good walking shoes. My orthopaedist strongly suggested Hoka's. They have an anatomical rocker bottom and can be really helpful for foot issues like arthritis, plantar fascitis, etc. Kind of pricey, but well worth it to me.

Hope you feel better.

[Darcy2000 in reply to SandyBoots]

Thanks very much ..my knee is feeling somewhat better the foot is an irritation. X-rays were taken and I am not sure if arthritis comes up in an X-ray but there was nothing particularly that came up in the X-ray

Will look in the shoes hopefully they sell them in Canada