Flare?

[Booboos171]

Hi, I'm after some advice please! I have searched 'flare' and looked at previous posts but just want to check...I have been on pred for almost 3 years and am down to 5mgs using the DSNS method of tapering. I've been mostly ok but developed tennis elbow around 2 months ago and have now also started to get pain in one thigh muscle and my hips are painful too. Do you think this is a flare? I've not been exercising as I usually do, apart from walking my dog. Now my legs from my hips to my ankles are really painful, especially in the evenings. I am not sure if it's PMR related or something else but wondered if it is worth taking the pred up to 10mgs for a few days? Any advice would be very welcome!

Many thanks x x x

[DorsetLady PMRGCAuk volunteer]

Could be, it’s hard to tell, but if it’s more on one side that the other would indicate something else…perhaps bursitis, or even osteoarthritis. But probably best to treat it as a flare initially whilst you try and get further advice/tests.

This post explains about flares - if you haven’t read it -

healthunlocked.com/pmrgcauk...

[Booboos171 in reply to DorsetLady]

Thank you Dorset Lady, I'll have a read of this today and make a decision whether to go up for a few days then.Many thanks x x x

[DorsetLady PMRGCAuk volunteer in reply to Booboos171]

Good - let’s hope it’s simply a flare (disappointing as that may be) and not another issue to add in! Let us know…

[PMRpro Ambassador]

I would suspect that the 5mg dose is just minimally too low - there is a little bit of leftover inflammation that isn't cleared out each day and it is building up. It all depends on how you define flare - you aren't going for zero and broke, you are trying to identify the lowest dose you can use without the inflammation building up. It could be 5.5mg, could be 5.25mg, but 5mg is just a bit too low at present.

The other possibility is a bit of trochanteric pain syndrome going on - that would account for what you describe as well. It can be part of PMR but it can be a problem in its own right and can be dealt with separately too.

[Booboos171 in reply to PMRpro]

Thank you PMR Pro, so, would you suggest I go up to 10mgs for a few days or just go back to 5.5mgs now? I've never heard trochanteric pain syndrome? Would a physio be able to help with this? Apologies for so many questions!Thank you again x x x

[PMRpro Ambassador in reply to Booboos171]

I don't really think more oral pred is the answer - unless it were a steroid shot for the bursitis aspect of the syndrome. It used to be called trochanteric bursitis but I suspect they realised it isn't as limited as just the bursitis. It is commonly found in PMR.

Yes, a physio should be able to help - there are exercises that may help if you can manage them and having a real physio to assess that is good. But the chances of getting an NHS physio appointment are dubious at present I;d have thought, I found the clam exercise in this handout helped.

ourphysio.org.uk/condition-directory/greater-trochanteric-pain-syndrome-gtps-of-the-hip/

The main problem when you have it and PMR is that the PMR is feeding the inflammation so just rest and icing isn't always the answer.

[Booboos171 in reply to PMRpro]

Thanks so much, I'm happy to pay to see a physio privately, rather than wait as it's bringing me down. Thank you again x x x

[Sharitone in reply to Booboos171]

I would be very careful about which physio you choose, Booboos. I was seeing one (based in a dr's surgery) who treated me for Greater Trochanteric Pain Syndrome, among other things. It was getting worse and he starting suggesting it was 'stress', but it was PMR all along. And there was me paying a morning's salary for half-an-hour of being made worse. I feel a good physio should know about PMR and be able to recognise it, as well as treating it appropriately.

[Booboos171 in reply to Sharitone]

You're so right Sharitone! I did the same before being diagnosed, I will make sure I'm cautious and that they understand PMR. Thank you x x x

[piglette]

Have you taken any painkillers? If so did they work? If they did work it is probably not the PMR causing the problems.

[Booboos171 in reply to piglette]

Hi Piglette, no i didn't, I try not to unless it's stopping me from sleeping or working and although painful, it's not at that stage yet. But it's a good 'test' I guess so will try it later! Thank you 😊

[piglette in reply to Booboos171]

I was thinking more of a test rather than just increasing the steroid dose.

[Booboos171 in reply to piglette]

Yes, good plan, thank you x