arthritis appearing at low dose pred

[Tiredcat]

For about a month or more I have been sore and stiff in a number of places, and I haven't been sure if it was because of gardening too hard, PMR flare or, could it be arthritis appearing? There are specific spots that are sore when pressed, e.g., a specific spot at the front of the shoulder, wrists, top of one fibula, one knuckle. I suspect it's not the same as PMR pain, but I'm not completely sure.

I think I have read on the forum at some time, that arthritis can be masked by pred , and as you get to the end of your PMR journey, as I hope I am, the arthritis shows up. Am I right in thinking I have read this here?

I am slowly dropping from 2.5mg to 2mg The pain doesn't seem to be any worse on days of less pred. I thought of taking an extra 5mg in case it was a flare, but I wonder if that would shut down arthritis pain too, so I still wouldn't know which it is.

I am now in my fourth year of PMR, so time has gone by and perhaps I am not going to emerge from it quite the same person as I was before! Though my mother did, she had PMR in her late 60s, early 70s, and we have photos of her at 84 on her bike. She died well into her 90s, so had many good years after PMR.

[SnazzyD]

What sort of gardening activities did you do? Are the points the same on both sides? When I got to low doses I got tendonitis which included initially small ones in the places that one tends to use repeatedly like elbows, wrists and fingers and top of shoulders, especially on my dominant side. Also, pelvic attachments, ankles and Achilles. If it were me I wouldn’t up the Pred without some initial concerted sleuthing first, which is what you’re doing.

[Tiredcat in reply to SnazzyD]

Thanks for you very quicky response Snazzy! Amazing that I am here on the other side of the world (NZ) and you can answer my question in a matter of minutes!Will look into the idea of tendonitis. At first I did think the shoulder pain could have been caused by strenuous use of loppers , cutting back an out of control climbing rose, while clinging to it's trellis and balancing up on a narrow bank, and trying to avoid the thorns of the rest of it. I suppose that's not what a 72 year old with PMR should be doing, but when needs must it's hard to stop a gardener I think!

[SnazzyD in reply to Tiredcat]

😮 That would do it! Loppers and weeding are the worst things for me. If it’s tendonitis, rest should give improvement. If it’s PMR, likely it won’t and as PMRpro is says, the location on the shoulder doesn’t rule that out.

[Tiredcat in reply to SnazzyD]

(Second reply) I have just looked up tendonitis on the Mayo clinic website, and the first thing I see is an illustration of a shoulder with a bright red patch exactly where I hurt! Of course there is some stiffness in the muscles in the upper arm too, but really I think you may have hit the nail on the head. Thank you !

[PMRpro Ambassador in reply to Tiredcat]

But be aware - those are also points where PMR can cause inflammation

[DorsetLady PMRGCAuk volunteer]

OA pain certainly resurfaces st lower doses-but yours doesn’t sound really like that. So maybe as SnazzyD says tendonitis.

Know exactly where you are coming from with the gardening 🤣😂

[Tiredcat in reply to DorsetLady]

Thanks for the reply D L. I am pleased to think it may well be tendonitis, Better than arthritis I think.

[Marijo1951]

I lost my more-or-less permanent knee pain (osteoarthritis) when I was on higher doses of pred. It returned when I got down to about 8 mg per day. I'm on 2.5 mg now and it's there, but I suspect not quite as bad as it would be if I didn't take pred at all.

[Tiredcat in reply to Marijo1951]

Thanks for replying Marijo.It's interesting.

[PMRpro Ambassador]

All attachments of muscle to bone I'd think - tendons or ligaments. It could be due to PMR or it could be a stand-alone episode of overworked tendons.

Do any coincide with the so-called fibromyalgia tender points? I found I had them with PMR, plus several more including wrists and fingers. Still have some when I'm having PMR/myofascial pain syndrome problems - my rheumy and the pain clinic doctor identify them absolutely unerringly!!!

creakyjoints.org/about-arth...

[Tiredcat in reply to PMRpro]

Hi PMRPro, I don't think enough coincide with the fibromyalgia tender points.I certainly don't want that!I might wait a bit longer and see if things improve, maybe lay off the gardening a bit, and if all else fails perhaps see my doctor.

[PMRpro Ambassador in reply to Tiredcat]

My point there was more that these are common to a range of things and I think tend to be a bit delicate if we abuse them All attachments - and they seem to inflame easily

[Tiredcat in reply to PMRpro]

I see what you mean.Thanks for your input, I always apreciate it.

[nallufl24]

I definitely had painful arthritis in my feet, back, hands before GCA diagnosis. The only good thing about the prednisone is that I had no pain. When I got to 10 mg all that pain came back but I’d still rather have the pain of arthritis than the side effects of prednisone

[Sharitone]

I hope you can sort your tendons out, but thank you so much for the very encouraging bit about your mother's recovery.

[MiloCollie]

You've made me think! I didn't knowingly have arthritis before my PMR diagnosis but now I'm down from 15mg to 7mg I have new aches and pains (awaiting xray results on hips and lower back). Maybe the last 11 months of pred covered it up? It's certainly a learning curve all this!!

[DorsetLady PMRGCAuk volunteer in reply to MiloCollie]

Certainly a possibility…I did have arthritis pre GCA….but of course during Pred days the pain was masked…..but came roaring back when I got to lower doses…..

[PMRpro Ambassador in reply to MiloCollie]

Or if it is poor adrenal function - that can also cause aches and pains ...

[PMRpro Ambassador]

journals.plos.org/plosone/a...

Maybe not yet?

[Tiredcat in reply to PMRpro]

Yes, PMRPro and Dad2Cue, in my dabblings on the internet I have come across the idea of late onset rheumatoid arthritis, but at this point, with the suggestion from the forum of tendonitis, I think I am probably suffering from overuse, and I hope if I can refrain from gardening for a while things may improve. I see how complex and hard to diagnose these things can be.