Confused flare or not

[UmiMck]

I posted a few days ago about left shoulder pain and tight area around left neck and scapula. Increased Pred does from 5mg to 10mg and taking 800mg of Advil. Stated to feel easing off the pain so dropped the Advil and now the pain has returned. Totally confused whether to drop back to my normal dose of 6mg Pred and continue with Advil.

[PMRpro Ambassador]

Too much ibuprofen/Advil alongside pred isn't a good idea as the combination can lead to GI bleeding. Have you spoken to the doctor about it? My similar muscle problems are an on-going problem which I had managed well with the input of the pain clinic - but that is in abeyance since Covidand it is building up. Another doctor offered lignocaine/lidocaine local anaesthetic patches and I do find they are very helpful with any muscle spasm attacks.

[UmiMck in reply to PMRpro]

So do I go back to my original Pred dose of 6mg.

[PMRpro Ambassador in reply to UmiMck]

If it isn't making any difference you might as well - no point taking extra if if isn't doing any good. Do you take stomach protection medication - like omeprazole? That makes the ibuprofen more tolerable alongside the pred.

[UmiMck in reply to PMRpro]

Just be taking Kefir yoghurt drink before Pred dose as I di intermittent fasting and don’t have breakfast till later on in the day. So how do I drop back from 10 mg to 6mg

[PMRpro Ambassador in reply to UmiMck]

Just drop straight back if it is less than 10 days - that is part of the reason not to stay high if it is doing nothing.

[UmiMck in reply to PMRpro]

I do have a script for Omeprazole but didn’t want to add to my meds of blood pressure, blood thinners,statins

[SnazzyD]

What activity were you doing prior to onset of symptoms?

[UmiMck in reply to SnazzyD]

Kayaking and helping my husband move some furniture around for carpet cleaning. I do 16 k kayaking every week without any issues

[SnazzyD]

Is there a possibility you’ve tweaked things from the furniture moving? The trouble with that is one does forceful movements under strain, usually over committing too. Pred weakens muscles, tendons and ligaments and we just can’t do those quick, give it a shove activities like we used to. If I did anything like that it would send my upper body into all sorts of trouble 2-3days later and I didn’t have PMR, just GCA and a Pred altered musculature. The shoulder is such a complicated area; you pull one muscle or ligament and it can refer pain up the neck, into the chest, down the arm etc. The fact that the Advil helped suggests it an acute episode from trauma perhaps. Advil is not good to take with Pred. Might be worth seeing a physio, chiropractor or osteopath to get a run down on what’s causing what.

[UmiMck in reply to SnazzyD]

Thanks. Will book an appointment with physio. Did not feel anything at the time of shoving furniture around. Hope it works. The doctors are not much help. So grateful to be on this site to get answers all hours of the day.

[PMRpro Ambassador in reply to UmiMck]

You very often don't feel anything at the time - it catches up later!

Just to say - I agree with everything Snazzy has said and it matches my experiences too.

[SnazzyD in reply to UmiMck]

One often doesn’t feel anything at the time unless is a bigger trauma. Micro damage can occur that isn’t obvious at the time and the inflammation doesn’t get going until afterwards, often reaching a peak at about 48 hours.

[UmiMck in reply to SnazzyD]

Another lesson learned about PMR. Will drop back to my original dose of Pred.

[herdysheep]

Doesn't sound like a flare, does it? I have a left shoulder/neck issue which I am pretty sure is not part of pmr. Walking (without carrying anything) can help. Also, careful choice of pillows and sleep position and a heat bag across the shoulders shortly before sleep, seem to ease it. Wrongly fitted bra straps and clothing that is too heavy can also be telling!

[piglette]

Advil normally does nothing for PMR, but as it seems it was helping it could be that it was helping something else?? Your pain may be associated with muscle pain or arthritis or …..

[PMRCanada]

Sorting out a flare, from pred withdrawal, and DOMS (delayed onset muscle soreness after doing too much activity), is certainly a challenge. If the pain is responding Advil, it may not be PMR related. Even 1000mg of Naproxen a day barely touched my PMR. Be wary of taking NSAIDS along side of pred.

Frustrating to figure it all out for sure. Hope you get some consistent relief soon.