Flare advice

[UmiMck]

Started on 15mg January 21 and been reducing slowly using one of the slow tapering. Got down to 5mg and now extreme pain in one shoulder and arm. Upped the dose by 5mg to 10mg and has not made any difference. Do I go back to 15mg for a day or 2 or preserve with 10 mg for a while.

Thanks

[PMRpro Ambassador]

I'd say seek a reason for the one-sided pain - have you done anything unusual recently? PMR flares are almost always bilateral and one shoulder being painful isn't typical. Could be bursitis or myofascial pain syndrome messing up muscles/

[UmiMck in reply to PMRpro]

It does not feel like bursitis. The pain is in the shoulder, neck and thoracic region Feels like a big weight on shoulder and tense neck musles

[PMRpro Ambassador in reply to UmiMck]

Sounds more like back/shoulder muscles and possibly sternocleidomastoid muscle tightness - Snazzy is the person to ask about sternocleidomastoid problems.

Ah - I see your reply to DL - you have done something then at a guess. Unfortunately PMR and/or pred does your muscles no favours. What would have been fine in a previous life is no longer and it is all too easy to upset muscles so they go into spasm and the result is what you are experiencing. With care, a flooding dose of ibuprofen (800mg, taken with food as a one-off) and heat for some hours may do the trick. And no more furniture moving ...

It also sounds as if 5mg might be a sdtep too far just yet - 6mg in 10 months is very good though.

[DorsetLady PMRGCAuk volunteer]

Couple of questions - As it’s only one shoulder/arm are you 100% sure it is PMR? Could you have damaged/overused the arm in question? Or maybe arthritis? Have you tried painkillers to see if they help? If so , then unlikely to be PMR.

If you think it is definitely PMR how long have you been on 10mg, it can take up to 10 -14 days to make a difference in some cases.

Once you’ve decided it is PMR, and you’ve been on the increase long enough and it’s still not working, then you may need a short time at 15mg.

But, you need to rule out other causes first.

[UmiMck in reply to DorsetLady]

I did help my husband push a few bits of furniture around for cleaning carpets. Did not feel that I was over using the arm. Tried all sorts of pain killers and nothing works.Only been on 10mg for 1 day and was hoping to get some relief.

I was feeling so happy that things were going well with dose reduction over 6 weeks.

[DorsetLady PMRGCAuk volunteer in reply to UmiMck]

Think you need to give it a bit longer than one day - This link gives usual procedure - just adjust doses in example to suit your situation, but having got to 5mg in 10months is quite quick, so do ease up a bit -

healthunlocked.com/pmrgcauk...

[UmiMck in reply to DorsetLady]

Thanks. Will ease up a bit. Was going quite well till I got to 5mg and started to feel a few aches and pain