Thanks for all the great information that you share. I read it every day and find it invaluable and encouraging.
On a personal note, I’d like to better understand how a flair feels when it’s first coming on. I was periodically reducing my pred and got down to 7.5mg for the last 2 days without incident, but yesterday woke up with significant pain in just one shoulder and upper arm.
That same shoulder has been giving me problems and I think I may have reinjured it using lopers to cut a dead branch my wife wanted removed.
Am I correct to assume that a flair would be more symmetrical, affecting both sides of the body? I bumped my pred dose up to 10mg just in case, but would appreciate hearing if anyone else has had a lopsided flair, and how I may most accurately recognize one. Thanks kindly, Michael
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MikeVanBC
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But in this particular incidence I would say yours is more likely to be as a result over overuse of the loppers! I find, good as they are, they play havoc with my arthritic shoulder! 😳. Maybe try painkillers or apply muscle heat gel - or even hot/cold therapy…although probably a bit late for icing - needs to be done first 24 hrs.
The extra Pred may have helped with any increased inflammation, but if it’s just muscular pain, then painkillers are the better option.
I didn’t have PMR, just GCA. However, after lots of steroids, lopping caused hurt in whichever shoulder/arm I had used preferentially to give it some welly, many a time. Even if it was just one branch I would pay, but impatience (waiting for husband) and wishful thinking usually got the better of me. If you were reaching as well, that’s double trouble. One sided pain and a recent strain event points to trauma to my thinking.
Usually a flare would be similar to how your PMR was pre-pred and so bilateral. But PMR tends to go for weak spots and start earlier there. But like DL says - I'd be blaming the loppers!!! You don't use both arms equally using them!
Thanks Pro. Does that mean it is conceivable a flair began on this solo shoulder? If it was primarily so, wouldn’t boosting pred settle it down? And how much pred would I need to test that premise?
I do suspect it was the lopper strain because it was a thick large branch that had me fully stretched and significantly ratcheting the arms. Stupid me. But if there’s any chance I can settle it down with pred, I’m willing to try.
I doubt it somehow - pred doesn't really deal with injury. It is an antiinflammatory but it won't improve muscle damage which is likely.
Using muscles in heavier than usual exercise causes microtears in the muscles and that is what causes DOMS (delayed onset muscle soreness) and what you have now is similar. In PMR and with pred the healing of those microtears is delayed - more pred isn't likely to help that. And you may have done some damage to other soft tissue, ligaments/tendons. I don't think pred will do much there.
Rest and icing is probably the place to start. It could CAUSE a flare though so be watchful. Did the 10mg result in any relief?
No relief from the 10mg and I did try 12 just now anyway. Can you please clarify what you mean when you say ‘IT’ could cause a flair? And what are the earliest signs of an impending flair?
Injury or a fall can upset the applecart. First signs of an impending flare? No answer to that, everyone is different. My wrists ache, especially the base of my thumbs, and I have night sweats again. I can't remember if that is how my PMR first appeared originally though, long time ago.
It just happened 2 days ago, so haven’t seen a doctor yet. I’ve had ultrasound and an MRI in the recent past that show there are problems with this shoulder, and I had a cortisone shot not long ago. I suspect it was a needless re-injury from using the damn loppers. Hopefully it will settle down in the not-too-distant future. In the interim it’s so darn painful that I found myself hoping it might be a flare that could be extinguished with pred. How bizarre is that?!
No - hearing the full story - I doubt oral pred will do what you want. The trouble is, if it is a local problem, you are likley to need more oral pred than is sensible.
Very interesting that you feel it on one elbow, as well as in your feet. I have had pain in my right shoulder and also in my right foot, the latter of which I ignored as irrelevant.
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