is it too soon to for a PMR flare ?

[seamaid]

advice needed please, I was diagnosed with PMR in August and started on 15mg Prednisone tapered 1 mg beg Sept to 14 mg and again beg Oct, to 13 mg ,aiming to repeat Nov 2nd to12mg but yesterday suddenly had shooting pain on left calf and can now only hobble around indoors, tried Ibuprofen , and Paracetamol to see of they made any difference but NO, so am surmising I am experiencing a " Flare " ? ( still very new to this so do not know !! ) I am now wondering if I should take another 5mg tab today ( I took my usual 13mg this morning ) but am nervous of overdosing myself . I would be so grateful for any advice . thank you very much.

[SnazzyD]

Not necessarily a flare. From the short description it sounds like you’ve tweaked something because it happened in a flash. Sometimes acute things aren’t magicked away by the usual painkillers. What had you done in the previous 3 days and what were you doing at the time it went ouch?

[DorsetLady PMRGCAuk volunteer]

Agree with SnazzyD , doesn't sound very PMRish...but would suggest you don't reduce on 1 Nov ..wait until you've sorted out what it is.

[seamaid in reply to DorsetLady]

Thank you for your advice and will certainly take it on board, |I am actually relieved it is not a "Flare" but as I did not know what a flare felt like I was concerned !

[HeronNS in reply to seamaid]

In my experience a flare is the resurgence of the original symptoms. Sometimes these are warning"niggles" one is tempted to ignore. They can occur during a taper when the body complains about the reduction in pred. This is why at the lower doses we encourage a very slow taper as this gives the body time to adjust. It also lets you know if in fact your dose has now become too low, as the "niggles" will begin to intensify rather than fading away. Rule of thumb - you should always feel as good (or sometimes even better) at the end of a taper as you did at the beginning. There are times when it's hard to distinguish PMR from another chronic pain condition, like osteoarthritis, or perhaps particularly troublesome if a person also has fibromyalgia, for example. But mostly it's the gradual recurrence of the original PMR symtoms.

[seamaid in reply to HeronNS]

Thank you HeronNS that is useful to know, this pain was a sudden piercing pain in my calf which instantly put me on my knees I was just standing still and going to pick up the duvet to give it a shake !! ( I think I was the one who was shaken - but not stirred ! )

[HeronNS in reply to seamaid]

I can imagine you were very shocked by that. Considering how extremely strong a muscle seems to be when it is in spasm I don't think it beyond the realm of possibility that something did get strained. I remember one night when I got the most awful cramp in my lower leg and didn't know what to do as it was in the front of the shin not the calf as "normal" and all I could think of was my physiotherapist telling me once that spasmed muscles can actually cause fractures (I think she was referring to the spine as at the time we were discussing the spasmed muscles in my back). It can be quite frightening having these incidents. Next time, try rubbing the painful place hard. If it turns out you have experienced one of these piercing cramps, you might want to consider a magnesium supplement. (btw, magnesium is another thing not to take at the same time as pred)

[seamaid in reply to HeronNS]

Thanks Heron, Yes I have had one of those front of legs cramps a couple of weeks ago Oh Lord they are REALLY PAINFUL 🙄

[SnazzyD in reply to seamaid]

Are you taking a magnesium supplement? Pred makes you lose it more readily. If I didn’t take mine, I used to get cramps or irritable muscles.

[SheffieldJane]

I agree that a flare is more like a return to previous PMR symptoms and you have probably inadvertently hurt your calf. I would urge you to see your GP however because of the danger of DVT that can present like that, particularly accompanied by heat and redness. If, as we suspect, it is an injury, I find the homeopathic remedy Arnica helpful. Jinasc recommends Flexiseq cream to rub in, both my husband and I have found this to be effective. ( both available on-line). I would pause tapering until it feels better.

[seamaid in reply to SheffieldJane]

SheffieldJane Thank you very much for your reply. I also have Arnica and did not think to use it ! and will keep a close on on it tonight so far no heat or redness. such a stupid thing to happen ,!!

[SheffieldJane in reply to seamaid]

These things happen. I got my husband a huge medicine/ yoga ball for his back pain. Sat on it, grabbed his hand as I lost balance and we both ended up in a heap on the floor, helplessly laughing and narrowly avoiding injury, he very nearly cracked his head.

[MrsNails]

Hi Seamaid

You n me both - but mine’s my shoulder & it’s giving me 😖

We have to remember everything isn’t PMR there is a Post on FAQ’s - it doesn’t explain what’s happened to you but explains the difference between a Flare & Tapering Steroids.

healthunlocked.com/pmrgcauk...

Kind Regards

MrsN

[seamaid in reply to MrsNails]

Thanks MrsNails. That is a good interesting and informative posting Thank to very much I have decided not to taper next week , but will stay where I am for a while. I hope your shoulder improves very soon

[MrsNails in reply to seamaid]

You don’t want to cloud the issue - hope it improves soon 🍀

[mgrogers99 in reply to MrsNails]

Yes....not everything is PMR!!! Thank you for the reminder which I think is needed often!!😃

[Viv54]

Hi seamaid, sorry to hear your in pain ! been off and on pred first time a year then a gap, this time almost 2 years . Both times i got horrendous Tendonitis ! It was agony so i know how you are feeling, i hobbled for weeks ! I will never really know if it was the pred or the PMR. My money is on the Pred though ! as never suffered before. It leaves your calves so tender ! In the end i went to my DR. One of my worst side affects was sweating really badly ,my Dr said that this was not helping and to drink more water. The second was to do very gentle stretching exercises and to push through the pain everyday ! Its hard to do at first but it really does help. Standing on tiptoes, sitting down and pointing your toes upwards. Loads of really good ones on <You tube> .Hope this helps it did for me.Best wishes Viv🌷

[seamaid in reply to Viv54]

Thank you Viv54 at least we can sympathise with each other 😀 I have been trying a few stretches - oh dear- I fancy it is a little bit better this morning so will see how the day goes

[Viv54 in reply to seamaid]

Great news !😊

[PMRpro Ambassador]

Probably worth speaking to your doctor - it sounds as if you may have torn a muscle fibre in your calf. It can cause excruciating pain when it happens - I did it just stepping off the kerb to cross the road!

medicalnewstoday.com/articl...

discusses treatments.

[Tarym]

I had a tendon suddenly and painfully ‘pop’ in my arm earlier this year, was just moving a chair. All down to muscle weakness caused by Pred. It took time to mend, I’m much more careful now and respect my weakened muscles!

[seamaid in reply to Tarym]

Thank you Tarym. as you say , it is a painful thing to do ! and I will also be more aware in future not that I was actually doing anything ! luckily mine is not too bad a one and the usual " Hot and Cold treatment, painkillers and GENTLE exercise will get me walking again very soon

[Telian]

Sounds like a strain from how quickly it happened. See your GP if the pain lingers too long. I ‘injured’ my arm just by putting it out to move cushions and the pain was something else - it took many weeks to recover and after an x- ray showing nothing broken could only wait until it gradually recovered. I had to increase my steroids for another reason and it helped the arm pain! I put the cause down to weak muscle from PMR as found no other reason for it. Neither Doctor, Physio or MSK could help. Hope you get some pain relief soon.

[seamaid in reply to Telian]

Thanks Telian, its a pulled Tendon !

[Telian in reply to seamaid]

There you go, can so easily happen. Hope you’re not in too much discomfort. 🌺