Post script to flare in reducing pred

[WillOllier]

I must add that I did a ridiculous thing last week and played tennis 3 times in 48 hours including a hard fought match. I’m sure this has perhaps not helped ☹️

[DorsetLady PMRGCAuk volunteer]

No, probably not……

For info, you could have either amended your original post, or added this as a reply to yourself….saves having 2 posts on the go on same subject.

[WillOllier in reply to DorsetLady]

Oh yes thank you will do that next time.

[PMRpro Ambassador]

Ah - now it's funny, I did nearly ask if you had done anything different recently ...

That would do it and increasing pred probably won't help - just time.

[WillOllier in reply to PMRpro]

Oh dear, I've just increased to 7.5 on basis that I was last OK on 2.5 and it was when I started to taper to 2 that the symptoms returned but take your point that perhaps an increase wont help given my tennis antics. In the past I have done varying increases. I got down to 2mg the first time I tapered from 20 following diagnosis in 2019 that time the Dr. advised going straight back to 20 for a month then 15 for a month then 10 and then reduction of 1 per month. That worked until I hit 5 then I had to go back to 10, I then got back to 5 and symptoms returned so went back to 10 once again to start the slow taper again. This time (2021/22) I managed to get down to 2.5 before symptoms returned so feel that perhaps 2.5 is the magic number rather than 5. Do you think I should see if 7.5 works this time based on fact that I was OK at 2.5?

[PMRpro Ambassador in reply to WillOllier]

Doesn't matter - if you don't feel a lot better in 2 or 3 days just drop back to 5mg and rethink. Can you not get 1mg tablets? 2.5 at a time at this stage is far too much to be playing with and I suspect 2.5mg is possibly slightly too low, 3mg might cut it though.

[WillOllier in reply to PMRpro]

Many thanks yes I've got 1mg tablets. I'll see how I am on 7 after 2 or 3 days then if no better are you saying drop back to 5mg for a while.?

[PMRpro Ambassador in reply to WillOllier]

You want to get lower if you can I assume? What I basically meant was that if 7mg isn't really helping, no point staying there. If 4mg works - no point being at 5mg. But I wasn't sure you had 1mg tablets.

[WillOllier in reply to PMRpro]

Yes I’d like to get lower but if 7 isn’t working after 2 to 3 days should I assume I’ve been over active and not increase further as that might not help? Sorry if I’m being confusing !

[DorsetLady PMRGCAuk volunteer in reply to WillOllier]

The situation is confusing because you’re not sure if it’s PMR (if it is you need higher dose) or if it’s DOMS (delayed onset muscle soreness ) from the tennis - and you just need rest.

[WillOllier in reply to DorsetLady]

Yes you’re right but my gut feeling is that it’s PMR as the pain I’m getting in between my shoulder blades is always a symptom when I’ve reduced too low. Think I’ll give it couple of days on 7 and if no better then up to 10 for a week and then try back at 5 and take it from there .

[PMRpro Ambassador in reply to WillOllier]

Overdoing physical exertion is thought by some experts to trigger flares - so it could well be.

[DorsetLady PMRGCAuk volunteer in reply to WillOllier]

👍

[PMRpro Ambassador in reply to WillOllier]

What DL said. You might try some ibuprofen gel (or wintergreen or the like) on the sore muscles - that would probably help DOMS but not PMR

[Blearyeyed]

😂😂😂 I love the wording of your post script , that perhaps your games of tennis might have caused it.

3 games in 2 days , that would definitely cause a flare , or could even cause that sort of DOMS pain in someone without PMR whom just hadn't played for some time.

Rest and warmth or ice and the usual gels , possibly some paracetamol ,some light massage and then some gentle stretches as the pain calms down will probably help the added non PMR pain of overworked muscles while your increased Pred dose deals with the PMR flare.

We have all made the mistake of feeling better and doing too much , it's especially a trap we fall into as the doses get closer to zero and we are feeling better in ourselves. We think we are just about over it and well now and jump up the pace to that of the old days before PMR.

Unfortunately , the body and brain may give us the feeling of being better but our bodies are not 100% match fit and we still need to keep pacing ourselves to get fully strong again and avoid non PMR pain for upto a year , even after we get to join Club Zero and the PMR may be in remission.

Hope it settles down soon , Bee

[WillOllier in reply to Blearyeyed]

Thanks Bee. I’m following your advice -more pred until things settle down coupled with the usual DOMS treatments. Have booked myself a gentle soothing massage👍

[Blearyeyed in reply to WillOllier]

A tip on massage , make sure it is very gentle and shorter than a usual session. Sometimes with PMR and other inflammatory or autoimmune conditions a massage which might have worked well before can add to the flare.

Massage can also cause it's own version of DOMS if your body isn't in top shape or you have inflammation when you have it. The rush of toxins from the tissues which is part of it's therapy for a healthy soul can cause rebound pain , fatigue , headaches and nausea for someone who is already in pain or unwell.

It is why I usually give the tip to people on here to have shorter , gentle massage rather than the deep tissue sessions , and I usually advice that it is a therapy best used when you are on your healthier , more pain free days rather than on the Pain days.

[WillOllier in reply to Blearyeyed]

A good point, I will postpone it until I get back on an even keel

[Flutterbies57 in reply to Blearyeyed]

I m in the same boat . Was going down to 1mg . I m in a mixed up muddled up world . Last 2 times I went to the Chiropractor my whole body flared both times for about 48 hours. Did I realise what it was …….no ! Sometimes we just need a reminder .

[Portopetro]

That is so interesting as I too am a tennis player and played last week a lot of hard tennis which I had not done before in a long time . My last match was Monday and on Wednesday I really started to suffer not with my joints but with my muscles . Reading Dorset Lady’s response I am now thinking that it must be DOMS which I had never heard of before . I have decided I will stay on my 3.5 pred and rest a little to see if I improve . Fingers crossed !