PMR? Rheumatoid Arthritis? Sciatica? What is this?

[Pumpkin213]

Was diagnosed with PMR in January, 2020. Put on 20mg Prednisone. Rheumatologist started lowering Prednisone by 1mg per month in February. Didn't do well. Was hospitalizedi in December 2020 with Covid. They took me off Pred. and put me on something else. Doctor put me on 10mg when went for next appointment. Then they decided I had Rheumatoid Arthritis and put me on Hydroxychloroquine along with lowering Pred. to 5mg. I can barely walk in the morning. My back, legs, ankle, arms, wrists etc. hurt all day. Meds plus 400mg Aleve kick in about 2hrs after taking and helps some.

[Longtimer]

My sister has RA, tried Methotexate, and the drug you are trying, neither worked for her, has been on Sulphasalazine which works a lot better. There are other DMARDS to try....talk to your GP.....hope this helps....

[Pumpkin213 in reply to Longtimer]

Thank you! I have been on Methotrexate both pills and injections. Couldn't tell any difference. Same with Celebrex. I really figured she would put me on something else. Thank you agIn.

[PMRpro Ambassador]

What time do you take the pred? The ideal time to take pred for optimal relief of morning symptoms in both PMR and RA is 2am - that was established in a study, not just patients saying it. So it might be worth trying that. But you need to make it clear to the doctor or to your rheumy nurse that your symptoms aren't being well controlled.

They must have had a good reason for using the hydroxychloroquine rather than another DMARD (disease modifying anti-rheumatic drug) - did they tell you anything about that?

[Pumpkin213 in reply to PMRpro]

I take my meds when I get up at 4:30-5. I will try 2:30.

She didn't say anything except that it had been shown to help with RA.

[PMRpro Ambassador in reply to Pumpkin213]

It is used but it isn't usually first line in RA.

Taking the pred earlier will give it more time to get into the system before the substances that cause the inflammation are released in the body, rather than having to wait so long. How long have you been on the HCQ? Some of the DMARDs can take 6 months to show an effect but if it isn't giving you a half-decent quality of life you need to tell them.

[Pumpkin213]

Thank you. I will look these up.

[Pumpkin213]

Have been on HCQ since the

[cranberryt]

My question would be why did they change your diagnosis to begin with. While there is some overlap in symptoms, there are some differences as well and getting a treatment plan that works is really dependent on the right diagnosis to begin with.

[PMRpro Ambassador in reply to cranberryt]

A study did find that there were insufficient differences between LORA (late onset RA) with a polymyalgic onset and PMR to be able to distinguish them in a patient presenting with symptoms of PMR that then much later turned out to be LORA. It is extremely difficult.

[Pumpkin213 in reply to cranberryt]

My Rheumatologist wants me off of Prednisone so she us trying different medicine. Doesn't make sense to leave a medicine, that works, because of the side effects for another with different side effects. My inflammatory markers have never been high so maybe that's why.

[PMRpro Ambassador in reply to Pumpkin213]

SHE may want you off pred - but if you what you have is PMR and not something else, it isn't her call. PMR rules!