What to do after fall

[Skier321]

I fell a week ago and hurt my back and neck. I was on 10 mg of prednisone at the time my PMR pain and stiffness scale was 0 - 1 and I was going to go down to 9.5 mg but I was stiff and sore from the fall and I got more pmr stiffness in my quad muscles and lower back and right groin which I still have. Do I need to up my dose temporarily or just stay where I am. I want to try and reduce to 9.5 but not sure when now

[DorsetLady PMRGCAuk volunteer]

Don’t reduce, until your aches and sound have subsided…and maybe try painkillers and normal RICE protocols for your ‘fall’ injuries rather than up the Pred…unless you feel you are flaring.

If that’s the case then follow the procedure advised in this link -

healthunlocked.com/pmrgcauk...

RICE

As soon as possible after an injury, such as a knee or ankle sprain, you can relieve pain and swelling and promote healing and flexibility with RICE—Rest, Ice, Compression, and Elevation.

Rest and protect the injured or sore area.

[Skier321 in reply to DorsetLady]

Thank you I didn’t know if I need to go up a few mgs for a week then back to 10 and start taper again .5 mg at a time

[PMRpro Ambassador in reply to Skier321]

Only if the PMR symptoms flare - but not to deal with injury

[DorsetLady PMRGCAuk volunteer in reply to Skier321]

Not really -unless your PMR flares.

[PMRpro Ambassador]

I certainly wouldn't try to reduce until you are feeling less sore. There is evidence that a fall can be enough to trigger a flare but a fall can also upset your back muscles and cause them to tighten to protect themselves from more damage and pain.

My rheumy tries ibuprofen for a week or two - always insisting on a PPI as well to protect your stomach. He does other treatments as well - he calls it neural therapy, a needling technique that stimulates the muscles to relax again. It has taken time but I've progressed from needing the ED 2+ weeks ago to being almost pain-free most of the time. More pred doesn't usually improve that sort of injury - keep if for the PMR symptoms flaring.

[Skier321 in reply to PMRpro]

Thank you I live in Canada on the west coast and here in Victoria 25% of people don’t have a dr it is a sin. You folks are a life saver I will stay at 10mg for awhile them reduce if symptom free. Based on what I read here no point to reduce unless 0-1 on pain/stiffness scale thank you Dorsetlady and PMRPro

[SnazzyD]

Won’t add to the Pred bits said by others. Will say though, that a week after a fall where injury occurred is nothing. There are the injuries from landing and then all the others from the undignified attempts not to hurt oneself. Worsening pain can come from yes, a flare but also from adopting poor posture or gait because of guarding one’s ouchies. Also, one can stop moving around thus stiffening up. I’d expect a couple of weeks discovering new bits that hurt. Soft tissue injuries often don’t go politely.

[Skier321]

When you are injured and have inflammation from the injury is some of your prednisone redirected to the injured area which leave less to fight the pmr symptoms and is that why you can have some symptoms come back until you are over the injury

[PMRpro Ambassador in reply to Skier321]

Not really - the pred gets into the blood system and so is all over the body. It doesn't have a map, it acts on everything. Like putting bleach in a bucket of water to remove a stain - but it might well remove the colour from the t-shirt as well!