Well as Ive mentioned, several times, been on pred since Oct 2016 after GP diagnosing PMR,( without any blood test initially, only from symptons), started at 40 mgs, am now down to 4 mgs, been a long journey, at any rate, having had an MRI, on affected hip, as ordered by rheumy, after having some severe pain issues, groin, hip, thigh etc, apart from the still, muscle tightness and discomfort in glutes, and hamstrings, results show several issues, ie, degenerative labral tear, hip effusion, synovial thickening, (synovitis?), tendinosis of the rectus femoris, minimal edema, small high grade tear of the anterior aspect of the gluteus medius tendon, and some fluid(bursitis) , I realize these are medical terminology, which was not really explained to me by rheumy, he rather recapped all, saying tendonitis, and bursitis found, At any rated, I am curious if any of you, have had tears of tendons happen, bursitis, tendonitis of the hip, groin etc, and have been told it,s wear and tear, or caused by long term prednisone, He suggested a cortisone shot in hip for bursitis, and am struggling with that decision, and trying to find out if that will help heal and relieve the groin and thigh discomfort, just reaching out for any input you may have, thank you
Side affects of long term prednisone?: Well as Ive... - PMRGCAuk
Side affects of long term prednisone?
I have 2 partial tears in tendons in my right shoulder, tendinopathy in both shoulders and tendinopathy in my left gluteus medius and minimus. Unfortunately my MRI was almost a year after developing PMR and many months after starting on prednisolone so I can't tell what has caused what.
The MRI also showed possible enthesitis changes in the area of my left glutes. That is the only thing that my Rheumatologist was willing to say could be linked (possibly) to PMR.
The proposed treatment for the tendon problems was painkillers and physio. Not particularly helpful but the physio did think that the prednisolone might be hindering my recovery.
oh thank you Seacat, well I am going to revisit my physiotherapist shortly, but do not want the invasive "dry needling" she did, I am even wondering if that had an influence on my pain issues, it was kind of painful during that treatment,
"the physio did think that the prednisolone might be hindering my recovery"
Or the PMR and associated myofascial pain syndrome - which is what does it to me!
Impossible to tell unless I was off pred or didn't have PMR neither of which are the case
sorry, again, what exactly are symptons of myofascial syndrome, and btw, he did suggest I keep on tapering, so my next taper will be to 3 mgs, have been at 4 now for about 6 weeks, although I am reluctant, in the event my tapering has brought on some of the painful symptons Ive had in last few weeks
If,and only if you reduce -I would be trying 0.5mg rather than 1mg. At such low doses, 0.5mg makes a big difference…so long as you have plain uncoated tablets they can be cut.
yes was thinking that would be the best to do from here on in, thank you
👍..just seen your reply to PMRpro-stress won’t be helping either-so maybe stay where you are until your son improves.
Another way to do it - according to my rheumatologist - would be to take 3 mg a day and alternate it with 2 mg tablets every other day giving you an average of 2.5 mg. No cutting that way.
Oops - that should be 3 mg every other day alternating with 2 mg on the days when you're not taking 3. Clear? (as mud, probably).
Yes it does, but have to say not a fan of alternative days… think it’s harder on the body. …and in your case, it’s at least a 30% difference day to day……better to have same dose each day.
But it’s up to you…..
True, no cutting, but quite a big change in dose from day to day and for many people at this low level it can be quite unsettling. Rheumies often suggest it - but there aren't many of them who have ever tried it themselves.
mayoclinic.org/diseases-con....
asahq.org/madeforthismoment...
my.clevelandclinic.org/heal...
It is the part of PMR that makes large muscle tender to the touch and which makes some doctors think it is fibromyalgia - a completely different thing
I have had tendonitis due to Medrol combined with a quinolone and both drugs can cause tendonitis. They do also mke tendons and muscles more delicate. But there is no way a doctor can definitely say that it was pred that did the deed in someone who has PMR since both bursitis and tendinitis are part of PMR. The main problem with steroids and tendinitis/ligament damage is found where too many steroid injections are given into a joint so they are limited to 3x in a year.
When used for hip bursitis they should be given into soft tissue local to the bursa, not into the joint, and I have had several over the years. They are the quickest and most effective treatment I have had for hip bursitis. Another option is extracorporeal shockwave therapy (an adaptation of the lithotripsy used for kidney stones) but that takes 3 or 4 sessions over a few weeks so takes a while to achieve good pain relief but it has no adverse effects and does last well. I don't know where you are in Canada but I know one lady has found a practice that offers it in Calgary.
Ok thank you , so injection sb into soft tissue, not joint, well not sure exactly what method my rheumy would use, I see people talking about ultrasound and injection ?? also, he said he only does injection into hip, shoulders, etc, not into groin or thigh area, too many nerves etc he said, so I may call ahead, see what method, and what is involved with injection, again he didn,t explain much, seemed to want to hurry me out,
u/s is usually used to make sure the needle is going into the right place when the injection is into a joint. Mine have only ever been done into my hip area or low back.
I don't imagine for a moment the situation with your son is helping
and don,t know if any of this is due to little extra stress, my son had bone marrow transplant on Oct 6, still in hospital, waiting for his own numbers, blood levels to come up or hold for a few days before being released, so each day I am a little anxious, he has been through so much, in hospital whole month of June, getting leukemia in remission, and of course treatment just ravaged body, then admitted Sept 30 , to go ahead with transplant, he is in best care at Princess Margaret, and they are experts as he says, so have to have confidence, still a worry,
I am sorry you are going through so much. I will keep you and your son in my thoughts. Please take care of yourself though. PMR can be a nightmare but hopefully you will figure out the shot situation so you can get some relief.Be well. 🌺
omigosh, you have some issues to deal with for sure, thank you for your response though
thank you, yes I have learned that over the course of the last few years, my son was diagnosed also in June 2017 with multiple myeloma, and had a stem cell transplant in Jan 2018, he came thru that pretty good, and was on maintenance drug indeffinitely, but apparently, developing a secondary cancer was a possible side affect, which he did get leukemia , diagnosed in May this year, so it,s been a hard journey, but with all that , he still stays positive, thankful for all he has, and the good care he is getting a PMH
Hi Arvine.I too have had some of the same issues as you especially in my shoulder and Hip.I have had PMR 2 years and Down to 5mg at last.My Rhumatologist Recommended Steroid Shots and I have now had a couple.I certainly would get them if I was you as they really help with pain and movement.Good luck on your Journey x
thank you, can you tell me though, was your injection done with ultrasound guidance as according to what I have read, that is the most efficient way to make sure injection gets to the right place? My rheumy doesn,t do the ultrasound method,
It depends on the type of injection - if it is into the joint space, u/s helps. If it is into soft tissue around the inflamed area, you don't need it.
I have had steroid shots in shoulder (once during early PMR years), several in both knees (again early PMR) and several in left hip bursa area (before hip replacement). All were in the last six years by my surgeon. I highly recommend them.
Before PMR, I had bursitis in the shoulder. Not obviously caused by Pred. The cortisone treatment - 2 x steroids administered by injected via ultrasound, one short, and one long acting, solved the problem. Not everything is the fault of pred!
I am pretty new to this - PMR - and still broken by it. My GP diagnosed my in October, I say 2 orthopedists - as my knee was the worst and I'd had some surgeries in my past due to my profession. Last orthopedist (terrific Dr.) said I had a meniscus tear - likely old (my 3 previous tears were to the meniscus on the same knee) and a ruptured Bakers Cyst. My R hip he checked with an Xray as I was nervous about AVN (what had me have a hip replacement in 2011) A dance career can be physically difficult. I was free from that on my R hip, but all of the bursae in my joints were inflamed. From what I am gathering given my research so far. PMR - little known about it - is a condition that is autoimmune based. The trigger can be from stress to bacterial or viral infection. For me I suspect that in spite of my 2 covid vaccines, I somehow contracted Covid (not a stretch since I teach in a college and my husband came down with Covid and I was in very close contact while he was actively infectious). I never had symptoms, and the rapid tests always were negative. But the timeline is there. The body goes into fight mode with infection, and I think my system simply went into overtime and high alert. I read a few article that said PMR can be seasonal, and or it can last 2-3 years then stop. I think the mystery is in the autoimmune response. When I meet with my rheumatologist for the first time in early December I have a list of questions. Isn't it possible that al of your structural issues (tears) are old injuries? Sometimes we can manage and not know we have them (I did). Bursitis and any inflammation of your joints is due to the response from PMR. Interesting article: rheumatologyadvisor.com/hom...
yes I’ve had both sides full thickness tears of gluteal medius and minimus tendons. Had the op to repair right side six months ago. Booked to have left side in April. Big operation. Done unwillingly by surgeon. He said too old, too far gone. Not me but the tendons😂
The recovery was difficult, long, physio not too arduous. Just patience needed. Crutches then stick. Driving at six weeks in an automatic. My surgeon uses a different method. Gluteal repair using LARS. Artificial tendons. You’ll need to google that.
Well have appt with dr tomorrow, has ultrasound results, and does say MRI warranted on report, so hopefully will be able to get one asap and also hoping not tendons involved , Im almost 76 and have a lot of other back issues going on, trapped nerve etc, Im a widow , live on my own, hard to get on with daily life already, so fingers crossed whatever Ive done , is not as serious as your issues, sound terrible to cope with, and I want to continue with taper of pred, so will see
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