Pectoral muscles

[HamishPMR]

I have had PMR now for nearly 4 years and I am on 5.5mg pred daily. My symptoms are the usual neck and shoulders ache but recently my pectoral muscles and upper back have been sore. Is this unusual? Hamish, Edinburgh.

[SnazzyD]

Hello, my first question would be , what activity have you been up to in the last three days? I hope you haven’t suffered too much disruption from the storm.

[HamishPMR in reply to SnazzyD]

Thank you SnazzyD. North of us and south of us affected by storm. Edinburgh, nada. I have not done anything out of the usual.

[SnazzyD in reply to HamishPMR]

How long have you had it? Did it come on suddenly?

[HamishPMR in reply to SnazzyD]

Perhaps over the last 7 days and yes gradual. I do weights execises 5 days a week but I dont think that is the cause. When I say weights 2.5K hand weights, nothing daft

[SnazzyD in reply to HamishPMR]

I know we’re all different but it was at low doses that my musculoskeletal system, particularly upper body fell apart and became even more susceptible to strain. Weights of any sort was out of the question. Have you stopped the weights and rested for a week to see if it improves? Removing potential “abusive force” as one physio put it.

When you say pectorals, do you mean definitely the muscles rather than where the ribs attach? Thinking possible costochondritis.

[HamishPMR in reply to SnazzyD]

Nono, definitely pectorals but am taking your advice and no weights for a week, and thank you.

[SnazzyD in reply to HamishPMR]

Giving up exercise is a hardship, I know. At least it’ll add another piece to the diagnosis jigsaw.

[PMRpro Ambassador in reply to HamishPMR]

Funny that wasn't it? My daughter in Rosyth didn't even have the wheely bins blown over, never mind away!

[PMRpro Ambassador]

Like Snazzy - I'd suspect an unusual action though one you wouldn't even think of! Is it the muscles? Have you tried heat?

[nickmits in reply to PMRpro]

HI PMR P.... Can you explain how heat can actually help because back in the day when this all started I tried everything heat massage acupuncture physio Chiro acupunc and ever helped one inch... because the way I'm understanding this PMR is basically in your blood system/auto immune system so I don't get how heat can help in anyway because of that.

[PMRpro Ambassador in reply to nickmits]

Heat sometimes works for spasmed muscles - not for PMR itself, just the add-ons, as I term them. Though I do find that warmth makes me feel better in general when stiff, doesn't relieve it much though unless it is the myofascial pain syndrome side of the whole thing

[nickmits in reply to PMRpro]

Makes sense... I have pain in all my muscles except my legs-- have it im my forearms too and I have freezing hands-- cant do much for Raynoids...

[PMRpro Ambassador in reply to nickmits]

Keeping core temp stable helps Raynauds. The core temp must be right or you add to the peripheral problems. Then wear really adequate clothing - many cases of Raynauds are made worse by NOT dressing properly. My husband often had patients appearing with query Raynauds - no, just not dressed properly for the conditions!

[HamishPMR]

I have not tried heat. Perhaps that and also stop doing my hand weights for a week. But thank you PMRpro, your advice is as always much apprciated

[nickmits]

Thanks for that it’s not about how I’m dressing because when I am at my office and I start typing my hands get even colder I have to wear a glove with the tips removed so I can touch the keyboard and when it is not even that cold out my hands get cold in the winter time I need to put heat packs in my gloves… is that typically auto immune ? it’s been like that for over 10 years, that I can deal with ,it’s the PMR that my doctor thinks I don’t have I’m down to 6 mg now but still lots of pain is what’s causing me my day-to-day misery

[PMRpro Ambassador in reply to nickmits]

It is typical Raynauds yes. Raynauds itself can be a symptom of an underling autoimmune condition so should always be investigated as to whether it is primary or secondary.

betterhealth.vic.gov.au/hea...

Was your PMR better controlled at higher doses of pred? You aren't reducing relentlessly to zero pred, you are looking for the lowest dose thatmanages the symptoms. That may be a very different matter - and 6mg may simply not be enough.

Pred itself can cause achilles tendonitis - especially in combination with a certain class of antibiotics, the quinolones. Even a history of using them can be enough, don't have to take them at the same time!

[nickmits]

Also PMR pro I’ve u ever heard of an Achilles tendon becoming very sore from out of the blue -I did not injure it … in certain positions I came out of the blue can your tendons get weak with prednisone or something I can walk fine but it’s certain or if I pull my toes back towards my shin the pain is out of this world I’m going to Physio and that doesn’t seem to be doing much