Has PMR gone?

[Breester]

Since December last year following spine surgery, I have been prescribed morphine & presently Tramadol & Ketoprofene. I am two & half years into PMR tapering down to 2mg of Prednisolone. This morning I forgot to take the Pred. No inflammation problems. Have been wondering for some time if PMR has left my body or the drugs I am taking mask PMR inflammation. Does anyone in the community have experience of this & how does one know when totally free of PMR?

I need the meds particularly at night as nerve damage causes stiffness & wakes me up every hour or so.

[PMRpro Ambassador]

"how does one know when totally free of PMR?"

When you taper to zero very slowly and then the symptoms don't come back - even 1/2mg can be enough to manage the inflammation but when you get to zero, no go! It can take weeks, even a few months for the inflammation to build up far enough to cause symptoms.

Even opiods rarely help the pain of PMR, ketoprofene might as it is an antiinflammatory but it is rare for NSAIDs to do much good.

And even 2mg pred can be plenty to substitute for poor adrenal function so you still need the finish off the slow taper to zero.

[Breester in reply to PMRpro]

Okay thanks for your reply. I will proceed with caution to zero. Have come so far no need to jeopardise the recovery 🙏

[dogwork123 in reply to PMRpro]

Hi Brewster, can I ask what PMR isThanks.

[Bcol in reply to dogwork123]

Polymyalgia Rheumatica

[dogwork123 in reply to Bcol]

Thanks.

[PMRpro Ambassador in reply to dogwork123]

One of the two disorders this forum specialises in - polymyalgia rheumatica and giant cell arteritis

[Pixix]

I take tramadol time release twice daily & morphine time release when needed. Neither of these seem help my PMR, I don’t think. I still get the bad shoulder pains & the fatigue of PMR. Just my experience, others may say differently! Take care, & hope you’re better soon.

[Mikeysaab]

Hi Breester- my experience was a little bit of trial and error. I stayed at 0.5mg and monitored for symptoms for about a month. Luckily I didn’t have any so I took the plunge. That was over 12 months ago and so far so good. My GP was helpful and still monitored my inflammatory markers and kept me under the Rheumatoligist he referred me to (NHS) . He was brilliant and I saw him a month ago and he did a thorough set of checks and tests and signed me off but said his door was open if any PMR symptoms reappear. I have OA issues in some joints and severe tendinitis and rotator bursitis in the shoulders but he concluded this is degenerative and not linked to PMR so I have a separate treatment plan going on for all this. I wondered if this was all linked to PMR but apparently not

[Breester in reply to Mikeysaab]

Thanks for your reply. As mentioned above will take conservative approach & carry on reducing over next 2 months. Very helpful to read about your experience at the end of your PMR journey. Similarly I got confusing messages from my body, conflating less & less mobility with PMR & reduction in PMR. In fact my spine packed up now fixed, this caused difficulty walking. For first time in nearly 3 years believe I will walk again & PMR will be behind me.

[Amkoffee]

I was on Morphine and Percocet for my back when I was first diagnosed with PMR. The pain meds didn't effect the PMR stiffness and pain at all. As I tapered I could always tell if my PMR was flaring despite the opiates I was taking for the back pain.