Painful shoulder

[Malcolm_T]

Confirmed, 12 May 2021, as having PMR, started on 15mg prednisolone down to 12.5mg but symptoms have returned to the right shoulder mainly. Now on 12.5mg and 10mg alternate days. Shoulder still painful. Rheumi suggests a steroid injection in shoulder as he does not want to increase the pred. Has anyone else had experience of this and is it worth considering.

[DorsetLady PMRGCAuk volunteer]

Depends what is causing shoulder pain…..if it’s PMR then it may help for a short while. If it’s osteoarthritis or other it may give longer relief. So you need to know what it is.

Before diagnosis my GCA was assumed to be frozen shoulder so injections given, only relieved pain for 2-3 weeks.

If it is solely PMR, then a higher dose of Pred is best option, despite Rheumy’s opinion…and to be honest the alternate 12.5/10mg probably isn’t doing you any favours. PMR likes a steady dose, not chopping and changing.

Personally I would be inclined to return to 12.5mg a day for a week and see if that makes any difference. If it does, then try cutting your 2.5mg tablet (if that’s what you have, and it’s plain white) in half - and going to 11.25mg per day, same result but easier on body

Did your shoulder become painful at 12.5mg or since the 12.5/10mg reduction? If former, you shouldn’t have tried reducing, but it is what it is…

But, personal opinion, more Pred required!

[Malcolm_T in reply to DorsetLady]

HI DorsetLady, Thank you for the prompt comment most useful. Will return to 12.5mg for a week and see what happens and then take a view. The pain returned when I dropped to 11mg and the rheumy decided to then change to the 12 - 10mg on alternate days. This has not changed the pain level.

[DorsetLady PMRGCAuk volunteer in reply to Malcolm_T]

Well maybe 12.5 is what your illness needs just now - won’t always be - but there’s a message there methinks.

PMR didn't get the memo about tapering- some Rheumies don’t seem to appreciate that unfortunately.

Let us know how things go.

I guess looking at your age, you’re still working, so you need to factor that in as well.

[Malcolm_T]

Hi, Thank you will do. Can I also say thank you for all the other posts and FAQ this has given me much more information than the Doctor or Rheumy gave.

[PMRpro Ambassador in reply to Malcolm_T]

We walk the walk - they talk the talk without knowing what the walk feels like ...

[PMRpro Ambassador]

Has he done imaging to have a better idea what it is? Being one-sided does suggest it may be something besides "just" PMR and oral red may not be the ideal. However - it COULD be the PMR being worse there than elsewhere and he may have to let you have a bit more pred.

As DL says - this alternating dose really isn't ideal for many patients. I wish I knew why they don't advocate cutting tablets or using 1mg tablets. So much easier on the body.

[Malcolm_T in reply to PMRpro]

Thanks no imaging done yet thought it would canvas opinions here as there is so much good advise before discussing further with my Rheumy.

[Pixix]

Following your post with interest! I get shoulder problems but always equal& one of the key symptoms on my diagnosis. But in past six weeks I’m getting dreadful pain in left shoulder which is ‘different’, & goes into the neck a bit. Feels muscular but I need to discover what it is!,! Lots of clinking/grinding of bones if lifted, or if I ‘circle’ it,& lying flat is only help (after 2 hrs the pain eases!) I taje tranadol &Paracetamol for other issues, but they aren’t helping! Ive never had shoulder issues before & haven’t googled yet to see what it could be! Hope yours improves soon.

[Malcolm_T in reply to Pixix]

Hope you find a solution soon. I have divided to return to 12.5mg for week to see if there is any improvement. I do suffer slightly with neck and left shoulder stiffness. Will keep you posted.

[Pixix in reply to Malcolm_T]

Sounds like a good decision on your part. In my time I’ve had four car crashes, none my fault, & three occurred when I was stationary, hence whiplash & neck issues. So sometimes it’s hard to know what relates to which disease or injury! Good luck!

[RolyB]

Hi Malcolm

My rheumatologist gave me steroid injections when I developed severe shoulder pain during my prednisolone decent. The relief lasted a few months each time, however, the pain turned out to be caused by a shoulder impingement and I had to have keyhole surgery.

So, as others have already pointed out, the reason for the shoulder pain could be other than the PMR.

Incidentally I've been off prednisolone since February, after five years of ups and downs, using the Dead Slow Nearly Stop method.

I also think the 4K units of vitamin D3 I was taking helped.

[Miserere]

Hi Malcolm,

I can see you've had lots of good advice here. I can only add that I have felt more pain and stiffness after recent reductions but it tends to reduce after a week or so. I am now on 8mg pred but will only reduce by 1/2mg from now on as my right shoulder and hip are sore at present, and both shoulders were sore for a couple of days when I reduced to 9mg. I shall wait it out for a few more days and if it settles that's fine but slowly, slowly from now on.

Hope all goes well for you.