I am a 70 yo male that was diagnosed with PMR in January of this year. Started on 20 mg prednisone and currently on my third week at 8 mg. Sunday morning I blew off the leaves in my driveway with a backpack blower. About 30 minutes later I had some light to medium chest pain and sweat for about a minute or two and then the sweats stopped, and the pain moved from chest to my back in a short time. The pain was about heart high and midway between the spine and right shoulder blade. It felt deep in the back muscles and in a small localized area. Kind of like a knife sticking in there and being twisted. The pain in the back worsened. My wife and I became concerned and I went to the E.R about noon. I TOLD them I had PMR.
They immediately started a protocol for heart issue. X-ray, CT scan with contrast, both negative. They decided to keep me overnight and do a stress test and Echocardiogram on Monday. The pain continued throughout the evening and they gave me 2mg morphine and it didn't help, then gave me 5 mg hydrocodone with 325 mg of acetaminophen which also did nothing for the pain. They tried a muscle relaxer called flexoril and no help. At 10:00 pm they gave me my 8 mg of prednisone and by about 2:00 a.m. on Monday the pain was diminished and by morning was almost completely gone. Note: I usually take my 8 mg but I take 3 mg at bedtime and 5 mg with breakfast. They would only give me the full 8 mg at bedtime.
I got the stress test Monday and the echo and both of those were good also. The hospitalist doctor reported to me that my heart and lungs were fine, and it must be related to something else. He mentioned acid reflux and told me I should probably see a Gastroenterologist and they released me. It never felt like tummy issues to me.
I didn't think this was related to the PMR as the pain was not bilateral and it didn't feel like the typical PMR type pain. Not so sure now, since it seems it may have been the 8 mg dose of prednisone that helped the pain go away. It is Tuesday morning and I took the 3 mg dose of prednisone last night and I seem to be fine this Tuesday morning. I've had an appt. scheduled (prior to this incident) with my Rheumy on Friday that I will discuss this with.
Has anyone else experienced this type of back pain and could it be related to PMR?
Thanks for the great knowledge on this board and sorry for the long story, but I wanted to include as much as I could.
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jsretaw
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What an ordeal. I honestly think that the clue is your leaf blowing activity prior to the pain. Our muscles are starved of oxygen with PMR and we injure ourselves very easily. I think that you experienced severe muscle strain in your trapezium muscle ( my husband did something similar with a violent sneeze, the pain sounds very similar). Prednisalone would help because it deals with all kinds of inflammation. However, you are seeing a proper doctor/ Rheumatologist soon who will hopefully explain what’s happened. It’s very important that we pace ourselves with activities our old resilience is simply not there. I am so glad your heart is fine, it is everyone’s first thought.
Probably a combination of things, but glad to hear it's not not heart related...
your PMR affected muscles probably took exception to the repetitive movements and weight of the blower,
the sweats may be due to the fact that you are around the level when your adrenals need to start thinking about functioning again, and the fact that the 8mg of Pred taken helped, may corroborate that,
acid reflux can very often give the same sort of pain that you describe, so yes, best to get that checked. It's not necessarily tummy trouble, but actually starts in the digestive tract around the top of your diaphragm area, which is why it's sometimes confused with heart issues.
You have reduced very quickly, so it is quite likely the PMR has raised its ugly head and bitten back. The fact that strong pain killers did not work also points to it. The only thing that really helps PMR is steroids. I am glad that everything else seems OK. It was good to be checked over to find you are in good condition!!
Hi there. Would just like to support DorsetLady's comment by saying that I have experienced episodes of acid reflux that have felt exactly as you described and they've also made me 'sweat' for a short period of time. May well be a combination of PMR and some acid reflux. Pleased it's not heart related. Take care.
Thanks for your reply. I have been vaccinated for shingles (shingrix) a couple of years ago. I also had it once prior to vacc and this doesn't feel the same.
I see. My shingles started off feeling like a knife. Then it subsided and returned feeling like the more classic form. I too have had Shingrix, but my immunosuppressants left me exposed. Also, there are bursae under your scapula that can become irritated with repetitive use. Only thing is that the pain of bursitis should get better with opiate analgesics. Acid reflux discomfort should improve (quickly) with a PPI
Maybe check the forum for other posts relating to upper back pain on one side? I found some posts and think I have settled on Rhomboid muscle pain, which came back (I get it on my left side only) when I reduced to 6mg Pred and went away when I had to increase back to 7.5. Mine's in the same area as you describe, but doesn't feel like a knife, more like a constant deep ache pain. I could put my fingers on it to trace the place between the shoulder blade and the spine - if I could reach it! A year ago I had a chest Xray (clear) for this just before being diagnosed with PMR and the pain was gone immediately I started on Pred. So no help really, just an observation of one-sided pain in the same area. I'm just reducing again to 7mg, it will be interesting to see if that constant deep pain comes back as I go down.
Too tired to go into detail just now - but myofascial pain syndrome goes alongside PMR but can be one-sided. It is caused by the same inflammatory substances.
Thank you PMRPro, I looked up myofascial pain syndrome, which sounds like my upper back deep pain. I see that steriod injections are sometimes used, that's probably why Pred helped me - I also got back the popping crickly neck once below 7.5mg. Also found some good Youtubes of rhomboid muscle stretches which I'll try as well. Or I'll stick longer at 7.5!
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