a single day relapse?

[Dots___]

I was diagnosed with PMR in 2018. After tapering very slowly, I am on 1 mg/day of prednisolone. I have had no PMR symptoms for over a year now, so perhaps I should have tapered off the drug entirely, but I felt like I still had some inflammation in my body, so I have held at 1mg. I have also been working on getting the optimal combination of diet, exercise and weight to keep inflammation as low as possible.

Yesterday I went swimming. I don't usually swim, but I'm trying to develop a taste for it because progressive osteoarthritis in my feet, ankles, and knees has limited what I can do.

Within an hour, I had what felt like PMR - stiff and painful neck and shoulders, heavy fatigue and felt generally unwell. I slept off and on the rest of the day. If I'd had enough pred in the cupboard I would have taken 5mg or so to knock it on the head. This morning, to my surprise, I felt ok.

It was a pretty active swimming session by my standards, but not wholly OTT. I do fitness classes and lift light weights regularly. I pace myself. I recently had covid, so that could be a factor. I am 62.

Is it normal to have a single day of full-on PMR symptoms like this? When I relapsed before, it was slower coming on and lasted longer. I would be interested to hear others' experiences or general information from those who know.

[PMRpro Ambassador]

"I don't usually swim"

That is probably your answer. You were using muscles and in ways you don't normally - and they are reminding you by developing DOMS (delayed onset muscle soreness). It would haooen if you were healthy too - but if you were healthy it would resolve faster as the muscles are better able to heal the tiny muscle tears that cause the pain and are the bais of training.

Whatever you do in the way of exercise you need to build up slowly - and that may mean just 10 mins to start with and adding just a couple of minutes every second day. That way you avoid what you have today but will get there ny getting into "training"

[Dots___ in reply to PMRpro]

Thank you and Dorsey Lady for your replies. Maybe, but I have never heard of DOMS coming on within an hour, or with that sick feeling of pmr.

[PMRpro Ambassador in reply to Dots___]

No, maybe not, but you had overtired your muscles so the brick wall of fatigue could also do that and that often manifects as nausea and feeling utterly awful. You were lucky it DID resolve and it is what usually happens to me - I retreat to bed and sleep and feel pretty much OK the next day but not entirely right - and I am closer to it happening again than had I not overdone it that day.

Have you seen the Fatigue post?

healthunlocked.com/pmrgcauk......

Look at the Sjoegrens link at the end - all those different sorts of fatigue.

And rememebr too that your adrenal function will not yet be reliable and an adrenal crisi may manifest with similar symptoms. I don't think it is a single factor - but bits of several.

[DorsetLady PMRGCAuk volunteer]

PMRpro has said what I would have, so won't repeat...

[Queenie1901]

I swim and have learnt to my cost that if I do too much the muscles in my neck, shoulders and upper arms stiffen up.. either later that day or the next day. I have always been a swimmer so it took me a while to judge what was enough (way less than I originally thought!) and what was too much. But I have definitely noticed the gradual improvement. And I would agree that after my first time back in the water the muscle reaction was quite swift!