Walking through into my kitchen two weeks ago and ‘pop’ - I thought something had hit the back of my ankle : looked down and it started to bruise immediately plus some pain . Trip to A&E & turns out I have totally ruptured my Achilles Tendon . I am now in a cast for 4 weeks with toes pointing downwards , can’t put any weight on it at all whilst in the cast and then I will have 8 weeks in a special adjustable boot which has to be worn 24/7 !!!!!
Then I read that spontaneous Achilles’ tendon rupture is not uncommon / associated with long term oral steroid use in older people. Just another side effect to deal with !!!!! My consultant agrees this is the most likely cause - although he is an ankle specialist his mother has PMR so he is quite sympathetic. I am waiting for an ankle replacement / fusion op on my other ankle but obviously until I get below 7.5 mgs he won’t operate due to risk of infection . Am currently on 10 : did get down to 8 but body wasn’t coping so increased to12 and now slowly tapering - again ( 4th time in two years since diagnosis)
The worst part is that after two days of using crutches my upper arms were really painful so have switched to self propelled wheelchair : fortunately we live in a bungalow so fairly easy getting around.
I don’t know if anyone else out there has experienced this but just be warned anything can happen when you are taking steroids.
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Swdai
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That is a bit rough - and I can imagine how uncomfortable you find crutches.
To be honest - I don't think it IS that common in patients on pred because in all the years I have been on the forums I have only come across maybe 3 with achilles problems - and I am one of them! Mine was also not due to pred alone but was because the GP prescribed a quinolone antibiotic while I was taking Medrol which is expressly contraindicated. Each alone can cause achilles tendonitis, together the risk is very high. Another was jinasc - she also ruptured the tendon but not sure how long she'd been on pred.
A & E commented that it is usually doing something energetic that causes ruptured tendon!! At that point I was not aware of the impact of the steroids !!!! Such is life and I take the view that at least I woke up this morning 😃
Best of it is that after initial rupture / bruising it is not painful : consultant says that is because it is totally ruptured and it is only painful when partially ruptured !!! Every cloud and all that ⛅😀
I mangled the lateral ligament in my knee - totally ripped so it didn't hurt at all! Which was something. And despite pred it healed perfectly with a brace for a couple of months - just as the orthopod said it would.
My sister ruptured her tendon last year. She had surgery and was in a boot for 6 weeks.Thankfully healed well. She has PMR and has been able to stop the prednisolone for about a year. She just had a flare before the holidays because of the stress of going to visit her family in Wisconsin from Florida. Her doctor put her back on a low dose of pred. and has now been able to discontinue again. It remains to be seen if she can continue without symptoms. Just thought I would post for any one's information.
I had big trouble with Achilles tendinopathy which started to hurt once I got to low doses of Pred about 2/3 years in. Yes, I do think Pred didn’t help because it was in other tendons as well, but they healed over months. However, I think the scene was already set by having acute tendinitis back in 2005 from Quinolone antibiotics that wasn’t recognised until it was too late. They healed but they were forever weakened I think. I think the Achilles’ tendons are harder to help because they do so much work just to stand. I know three non Pred friends over the years who snapped theirs and they did it doing nothing but walking on a flat surface. In all three cases, excess weight was blamed. I remember a lady on this forum a while back snapped hers walking on sand at the beach, I gather not long into the walk. My tendons didn’t snap and were helped by orthotics in my shoes and exercises, particularly to ‘clean up’ my gait which had got a bit wonky due to weak hips and thighs, that caused what I am told was an abusive force on already battle weary Achilles’ tendons.
I have experienced pulled and torn Achilles a few times in the last few years and the dreaded mighty boot.
My experience is slightly different to most though , it was the combination of another health condition called Ehlers Danlos Syndrome which reduces collagen production and causes increased subluxations and dislocations of the joints , and to some extent the effect of steroids on collagen that caused these more regular injuries for me.
The Achilles may take a little longer to heal and strengthen if you are on higher steroid doses, but the upside is its less painful while it heals and the inflammation decreases much quicker.
If you have been prone to ankle injuries , or you know of hypermobility in your medical history, this can cause more risk of Achilles injuries when you have other joint related health issues as you can be a little more wobbly and your gait changes. Steroids can sometimes cause less elasticity in your tendons which can cause some extra risk of tendon strains.
I gave up on the crutches under both arms and used my sticks instead because it did cause so much added pain in my neck and shoulders, plus they never seem to fit right under the armpits.
The boot was a nightmare through the night , my advice is get something cushioned to wear on the other leg because the amount of times I turned and clipped my other ankle and bruised or cut it I should have worked out to do that a lot sooner. I wore a long fluffy slipper boot on the other leg in the end.
Also moisturize your ankle and leg when you have the cast off and you have the weeks using a boot , and put a good thick long sock under the boot or your skin can get dry , rub and get little scrapes . You do need to take the boot off at times through the day and give your leg a good rub to help your circulation.
Thank you but after initial rupture / inflammation it is not painful at all and that is because it is a total rupture - apparently it is only painful if it is partially ruptured : every cloud and all that springs to mind !!!!
Note I don’t have PMR but Stills Disease which for me manifests as RA joint pain and damage, immobility and some overlapping things with PMR and Lupus.I read your post with interest as since October 2020 I’ve been struggling with a leg injury. I had a grade three rupture of the soleus (lower leg) and gastrocnemius (mid calf). Due to covid I had no treatment and 3 months later still could not walk and suffered sharp pain. Later a scan revealed unhealed muscle. Telephone physio has hardly helped. Due to wrist pain I cannot use crutches. The injury happened while doing very light stretch and step at home. I have not taken steroids since my mid 20s now nearly 60😖
I suspect Enethitis. I have a permanent limp and disability now but the main issue is pain and when added to RA pain and other AI ailments it’s all too much.
If I find any thing of interest I’ll let you know. Keep well.
Thank you, I’m equally frustrated with it and to find myself retired early due to company closure during covid. If my leg were better I could do something…. But can’t stand long, walk with any speed and throw in the other joint mobility I could be a liability 🤨Thank you for your concern 🙂
with me, not an Achilles problem, but many years ago I was prescribed a quinolone, Levaquin, and a few months later had a torn retina. During a recent hospital, I was given intravenous Levaquin and experienced horrible, scary nightmares with a racing heart rate. Now Levqaquin is on my list of allergic reactions and not to be given unless no other option. Wonder if the quinoline caused your problem.
Hi. Yes, prednisone weakens the tendons and this info is mentioned, albeit briefly, in the contre indications. I ruptured my Achilles’ tendon, and like you, was in plaster for 3 weeks, toe pointed downward and then a boot for 8 or so weeks. It is absolutely fine now, a year on, so worth following the advice to the letter. I think care is needed for any false moves when on pred, and if you look at my other posts, you will see what I have written on this, plus replies. Might be helpful. Good luck.
I haven’t actually ruptured mine ( I don’t think ! ) but they are so painful after about 10 mins into my walk. The left is worse than the right. I too have orthotics for my shoes now to see if that helps the problem but I expect it will be several months before I see any improvement. PMRpro did tell me that the PMR can weaken tendons as well as muscles ( or was it the Pred ? ) either way it’s very debilitating. Sometimes the shooting burning pain is unbearable and I limp back home with the dog looking puzzled. 😂
Could be partially torn tendons causing pain . When it is fully ruptured there is no pain after initial rupture / inflammation . Probably worth asking for ultra sound scan asap and see what the problem is
Hi swdai, even though my husband not on steroids he a both Achilles’ tendons rupture second on 2 years after the first, consultants both said it’s because his on Statins. If your on statins for cholesterol that could be the reason?
What a pit, it is so painful! I had lots of problems with my tendons 6 months after starting pred ! Woke up one morning thinking id walked to far ! My Dr did not have a clue which made things worse . It settled down on its own, but 2 years down the line my legs are still very tender . Hope you get sorted out soon.Best wishes Viv🌷
After initial rupture / inflammation it is not painful due to the fact it is a full rupture : it is only when partially ruptured it causes pain !! Every cloud & all that !!!!
I haven’t ruptured my Achilles’ tendon but have quite badly sprained it. I had been trying to get a blood sample, stay with me, and after 3 finger pricks I didn’t have enough and couldn’t get the blood to flow. So I thought I need to get my heart rate up and decided to run on the spot. Well I soon discovered this was a really bad idea, the top of my calf my went bank and hurt like hell. I then hobbled across the room and as I did my Achilles’ tendon in my right leg also joined the party. Some 4 weeks later and my left leg calf muscle is a lot better but I’m still struggling with my Achilles’ tendon in my right leg. All this to get that blood sample to send off to check vitamin D levels. Just as well I did as the results came back showing I was at the very low end.
Next time - just warm up your hands!!! The worst bit of getting a fingerprick sample is the capillaries being dilated enough. Doing OH's INR was hopeless unless he'd had his hands in warm water first ...
Sorry to hear of your problems!I damaged my Achilles’ tendon at the ankle in left leg about 20 years ago, and to this day it causes intermittent discomfort. For the past month or so it has been worse. So being the semi-hypochondriac I’m concerned having read your story this morning!
I have been on Pred for 25 months, starting on 15mg and with a spell at 20mg. Currently on 5mg reducing at 0.5mg per month.
I guess the problem with Achilles and skin thinning are related (collegian?). Do you or anyone else know how long it takes for the effects on the skin / tendons to be reversed once you’re off Steroids?
I wish doctors would warn us of the side effects, particularly if they know about previous injuries / health issues.
Most doctors claim the effects of pred aren't reversed. I suppose it depends on age to some extent - the younger you are the better the chances. Some things do improve markedly - like weight and skin. In some people muscle tone returns - Skinnyjonny climbed Annapurna IV just before Covid appeared having recovered from PMR that had had him in a wheelchair.
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