Is this a flare?

[ttabby22]

I'm only recently diagnosed with PMR so very much at the start of my journey, and I've been prescribed Pred - 20, then 15, then 12.5 - over a period of 3 months. I've been very physically active over the summer (digging on an archaeological site) which might have caused this, but I now get night headaches and slight jaw stiffness - most other symptoms have pretty much gone but I just get this pain in my head (and some fatigue). Not very sensitive around the temple area, so I'm hoping not GCA. Is this a flare I wonder and have I reduced Pred too soon/quickly? Have I been too active? The headache and stiffness go almost as soon as I get up. Any advice very welcome.

[DorsetLady PMRGCAuk volunteer]

Hi,

Have a look at my intro post - as linked in your other post…and yes probably too quick a reduction and summer activity not helped…

If the headache and jaw stiffness (so long as it’s not claudication (I.e. hurts when you eat, stops when you stop chewing) go quickly, probably too low a dose…maybe try going back to 12.5 and see if it helps.,

If it does, stay there for 3-4 weeks before reducing again….

This link gives advice on how to treat a flare- hopefully you won’t need to go higher than already suggested…but you may do -

healthunlocked.com/pmrgcauk...

[SheffieldJane]

The symptoms of non cranial GCA can be far vaguer than Temporal Arteritis. Having been diagnosed with the former after basically feeling unwell although PMR symptoms were definitely receding. I would pay attention to these symptoms and mention them to the doctor. Unfortunately, the incidence of GCA/LVV is high in PMR sufferers. Just something to be aware of. I would follow DorsetLady’s advice and see how you go. You do need to take the fact that you now have a significant autoimmune disease and seriously, pace your activities and have plenty of rest. You need to do a slow steady taper as outlined in FAQs to succeed. No matter how inconvenient this interruption to your normal life must be. As we all understand.

[PMRpro Ambassador]

I doubt your fun digging caused the PMR, although there are experts who think that excessive physical exertion can tip the balance. But that is a speedy drop in dose - fine as long as it works. Watch the headache and jaw pain - take it seriously if it gets worse or the jaw pain becomes noticeable when chewing or speaking a lot.

[Broseley]

When I was diagnosed with PMR I was put on 15mg, but I also had a headache in the occipital region and jaw stiffness and aching on chewing which didn't quite clear up on 15mg, though was barely noticeable. When I reported it, my GP made me take 60mg pred there and then, then sent me off to the urgent assessment centre the same day, where they diagnosed GCA and upped my pred daily dose to 40mg. So I would be really proactive on this one. GCA can leave you blind, so it's surely better to get assessed properly and be better safe than sorry.