I have had neck ache for about a month now. I assumed it was a flare because my crp on 24 Dec was 27. I was advised to increase pred from 3mg to 5mg for 2 weeks. Crp went down to 26 and neck ache was still there. I posted about this on the forum and it was suggested I increase to 10mg for a couple of weeks. I did this and I have had another blood test today. I will get the result in a couple of days but I am not optimistic as the neck ache persists.
PMRPRO suggested I might have a problem with my sternocleidomastoid muscle, and that this might not be alleviated by pred. I'm now thinking this might be the case, given the lack of improvement. My questions are a) Does pred always reduce inflammation if the dose is high enough; and b) If the pred isn't helping is it worth trying something like paracetamol; and c) I suppose it is possible that the neck ache and raised CRP are purely coincidental, and the raised CRP might be caused by something else?
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Jontie
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Always worth trying paraceetamol early doors - if it helps it is probably NOT PMR. You will always find doctors who claim pred makes everything better - no it doesn't! If your pain doesn't respond typically to pred, i.e. at least 70% and pretty speedily, it MUST be considered it may not be PMR and investigated. But there are atypical PMR responses, or at least, they can't find another diagnosis, which leaves PMR that ok a long time to respond. The difference between 27 and 26 in a CRP tet is within the error for the assay - so pretty meaningless.
It may be related - we talk a lot about myofascial pain syndrome and sternocleidomastoid pain can be part of that too - and it is more common in people with PMR, It isn't a simple link though. Heat and physio may be very helpful too
I can't help as such, but....! I have aggressive arthritis as well as PMR so I have taken Pred and Cocodamol for over 10 years. As far as I know 'I'm not dead yet'!😂😂
it's always worth giving Paracetamol a chance , over a couple of days first too see if it will help a non PMR pain.
If it does , or it doesn't you at least have the information there to tell your GP that antiinflammatory type meds aren't working.
If it doesn't work at all , it could mean that it would be beneficial for you to have an xray to rule things out , and you may find you have a nerve pain instead which can be relieved with a neuro medication instead.
This could be for a short term issue like a trapped nerve. Even after the nerve is not trapped the pain the nerve gives can last a number of weeks and antiinflammatory medications only give a small amount of relief for that.
Not sure you can say antiinflammatory meds don't work just because paracetamol doesn't work - its antiinflammatory effect isn't that great, some say it has none. Works as an antipyretic.
I think i have used poor grammar , sorry , what I meant was if you also tried the paracetamol , and both the pred and paracetamol were not making a difference to the pain , you could tell the GP which could help them decide if other tests were required . Sorry , I was in the midst of an all nighter as I took part in a Q and A with a group of people in South Korea on Hieronymous Bosch in the early hours ( the artist not the TV detective
😂😂😂). I could really do with a nap now but i haven't managed to get off since.
Quick update. My crp has reduced from 26 to 6. So the increased pred has presumably reduced the inflammation, but the neck ache persists (and paracetamol hasn't helped). So can I assume the neckache isn't pmr related, and maybe some sort of massage or heatpad would help? I've only been on 10mg for a couple of weeks so I'm planning to reduce to 7.5 for a couple of days, then 5mg,abd and taper from there. Does that sound sensible, or is inflammation likely to recur? (4mg previously controlled my symptoms well).Thank you.
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Reducing Pred for first time
ESR and CRP slightly raised, neck, shoulder and legs a little stiff, back too. How much should I increase Pred by? 
Symptoms reduced but ESR/CRP unchanged 
