PMR Symptoms?

[SMH4CRNA]

Tapered to 1mg as of Sunday. Take medication in the PM.

At this dose these are my symptoms:

Swollen fingers

Stiffness (not specific to AM) to shoulders, back and thighs

Pain to the neck/trapezius

Symptoms responsive to NSAIDS, Tylenol and Celebrex.

At 1mg, no longer feel dizzy, light headed, nausea or fatigue. Did suffer at 2-7mg.

Currently following Rheumatologist and Endocrinologist's guidance to taper prednisone. I will admit I am responsible for dropping a mg per week. They suggest 1-2mg per week. I honestly am not getting relief with 1mg of prednisone, but did at 2-3mg. All imaging, MRI, CT and PET scan negative for PMR. CRP/ESR still slightly elevated. All other labs WNL. All current symptoms are similar to symptoms felt prior to prednisone at a lesser degree.

Is this simply 49yo osteoarthritis?

[piglette]

The fact that painkillers such as NSAID s are helping the pain does suggest that it may not all be due to PMR. However why don’t you increase your pred dose by 5mg for a week, see if you can really hit the PMR on the head and then drop back to say 2mg or 3mg and see how you go?

[SMH4CRNA in reply to piglette]

Yes, this would be the best course of action, but I'm resistant due to my reluctance to admit failure with the taper. If these symptoms continue I will notify my Rheumy for guidance. Although, I concur with your thoughts for a remedy.

[Jackoh in reply to SMH4CRNA]

”I’m resistant due to my reluctance to admit failure with the taper” Unfortunately PMR has a life of its own and isn’t there dependant on how well we taper. As we say on here too you aren’t working at getting to zero no matter what. You are titrating the dose to reach whatever dose, at this present time, seems best for your body - not according to some given formula for reducing ( usually formulated by GP or Consultant) come what may. It appears you may have gone past what is the right dose for your body at this present time so would agree with piglette’s proposed plan of action. 💐

[DorsetLady PMRGCAuk volunteer]

I think you need to discuss with consultant, as their opinion is you don’t have PMR. Although some of your pains could be PMR, the fact that they can be relieved by painkillers obviously puts doubt into the mind.

Although as suggested a short increase may help, and in normal circumstances with PMR tapering I would agree, but not sure doctors will be happy with that.. and in this case think they might be right.

I know you are in a bad way at the moment, but just not sure it’s all down to PMR….and if it’s not, then a lot more investigation needs to be done, and doctor obviously thinks being on Pred will not help in that.

The fact that nausea and dizziness has lessened is a good sign.

Please keep us informed of how things go.

[PMRpro Ambassador]

I really don't have anything to add to what DL has said. If ordinary painkillers deal with the problems it really is far less likely to be PMR. Steroid withdrawal will often respond to painkillers and can closely resemble the original disease for which you are taking the pred. The speed with which you are reducing is pretty likely to cause that.

[SMH4CRNA in reply to PMRpro]

concur, but wow the symptoms are the same prior to starting prednisone. I increased to 2mg last night and 90% of symptoms have resided. Dizziness and nausea has returned this AM. Muscles aches due to withdraw and d/n/v due taking prednisone. Damn if you do, damn if you don't.

Thank you all.

[PMRpro Ambassador in reply to SMH4CRNA]

True - but the speed you have reduced I'm pretty sure there is some adrenal insufficiency mixed in there too - and extra pred should improve that. It is a very winding road at this stage ...

[SMH4CRNA in reply to PMRpro]

Indeed a wi dy road it is. Today I feel better on 2mg. I am going stay here for a bit I fathom. I will be honest, my gut says this is more than osteoarthritis. Hands don't swell with osteoarthritis.

[PMRpro Ambassador in reply to SMH4CRNA]

Gut feelings should not be ignored ...

[Hidden]

I too am experiencing shoulder and nack pain, and on turning head I feel cracking in my neck.....all this I'm putting down to Osteoarthritis