After a long and arduous journey I’ve made it safely to the US to visit my son and family for Christmas. I’ve now had three days to rest and recover. I was experiencing a flare before we left England and I’m now on day 10 of an increase from 8.5 mg to 13mg. The increased dose over the past 10 days doesn’t seem to be making any difference and I’m suffering with constant aching in both shoulders and arms. Yesterday I tried taking a small dose of Ibuprofen and some paracetamol in the evening but nothing is helping.
It was my intention to reduce to 10mg Pred tomorrow for three days then drop to 9mg until I got back to England in early January. This is all new to me. In the past increasing my Prednisolone has always eased the pain. I have plenty of Prednisolone with me just in case but can’t help thinking that something else is going on. I would be grateful for any suggestions please?
Written by
Tiggy70
To view profiles and participate in discussions please or .
If this is the PMR it could well be a real relapse of the underlying autoimmune disorder - has anything improved at all with the higher dose? Did you have the localised arm and shoulder aching right from the start? Had you done anything that might have caused it just before the aching started?
A small dose of ibuprofen is useless because of the way it works. The correct way to use ibuprofen is an 800mg flooding dose to start with and then top it up with lower doses to maintain the pain relief. I suggest you try that first - see if it works. Adding heat often helps relieve muscle spasm.
Thanks for your prompt reply. Nothing has improved with the higher dose. The shoulder and arm aching has been there from the start. It had been getting increasingly worse for a few weeks but I was recovering from major shoulder surgery and the consultant wouldn’t let me increase the Pred because of healing issues. I had upped my activity level prior to travelling but nothing major, just packing etc. I’ll give the flooding dose of ibuprofen a try thank you. Do you think there any point continuing with 13g of Pred for another 4 days?
If it has made no improvement at all, probably not. But it is up to you. It is horrible feeling rubbish when you are away from home. You can take the 24 hours does of both ibuprofen AND paracetamol together if you want to try to see if that helps the ache.
Did it all start after the surgery? I find that can go for upper back muscles something rotten if you are put in a particular position.
My surgeries were on 14 September and 11 November. The aching started before the second surgery and I suspected a flare. Nowhere near as bad as it is now. Because my shoulder wasn’t healing very well and the imminent second surgery the consultant wouldn’t let me increase the Pred. I had some lower back pain after my first surgery and asked for a pillow at my lower back for the second which helped. The surgery was done in the ‘deckchair’ position.
I suspect a combination then - but difficult to know what to do under the circumstances. Other than MAYBE up the pred even further for a couple of days to see if it helps.
As you say difficult to know what to do. When I was first diagnosed with PMR over two years ago I was put on 15mg Pred. My pains were almost 80% gone after three days…..
You can stay at increased dose for a few more days (up to 14) without jeopardising your subsequent reduction so I would do that, and also as PMRpro suggests in case it’s not all PMR.
Thank you for your reply. I’m feeling so low at the moment and hearing from you and PMRPro has made me feel less alone. My family are very supportive but don’t know what to say to me. I’ve just taken the 800mg ibuprofen and I’ve got a heat pad across my neck and shoulders - fingers crossed I get some relief🤞x
at the risk of showing my ignorance; I’ve pulled a lot of muscles in my time breeding horses and the last resort solution to bad muscle pain was Diazepam. It was the only relief and rest I got and often only for a couple of nights together with heat pads.
It’s horrible being away and feeling rough - but give in and don’t overdo things. They won’t mind terribly as long as you’re comfortable. Good luck. Blessings
Is there any chance that your flare pain has been enhanced by neck and shoulder strain from lifting luggage, having to hold your head still during road journeys and sitting upright for long periods? In other words it’s some muscle trauma rather than all PMR inflammation.
Hi. There is that possibility of the travelling aggravating things but I was having the aching well before I left home. I suspect that the problem has been building up for a few weeks.
See if you can get some relaxing exercises or something. The heat pad may help but if you have tension in your body you might benefit from a massage - from a professional or at least a person who knows about PMR. My physiotherapist is an expert at working out the tension in my neck and shoulders, which does help associated pain - I have lot of osteoarthritis in my neck, so in my case it isn't always PMR although that is certainly most vulnerable location if I flare.
Thank you for the suggestion. I too have osteoarthritis in my neck and shoulders. I’m away in the US at the moment but I’ll certainly consider it when I get home after Christmas. I’m seeing my physio in early January so I can ask for her advice.
sorry you are having a tough time Tiggy, just when you want to enjoy your long awaited trip. I will say even before I got PMR as I got older the long haul trip to see my children in the USA did me in. After getting PMR I could hardly function for a few days even without the recent surgery you have had. One time I went to a walk in clinic and they gave me an intramuscular injection, which worked miracles. I would take as much pred as you need plus the ibuprofin, you probably still have residual pain from your surgery’s as it’s barely been six weeks. I think acceptance is the key, that you cannot do a lot of the things your family have planned for you. Just enjoy their company. Hopefully each day you will feel better. x
Thank you. I just hate feeling this rubbish and not really knowing what the best course of action is. The extra Pred and large dose of Ibuprofen helped a bit yesterday with the aching but I felt so drugged up with all the medication. I hope that you are feeling better. Have a lovely Christmas, Tiggy x
I often ask my sons or hubby to help rub my muscles and that just barely takes the edge off. I do find a good massage does help me, but it is expensive and so I don't do it as much as I used to when my insurance used to cover it. I recall once while in California trying to find a good massage therapist while on a trip, it was NOT easy and the pain was nasty (but that was all pre-PMR). I'm hoping you find some relief!
I've had one before - it was quite good. I used to get prescribed massage in Germany - wrapped up in a fango pack (solid mud wraps) to soften everything up before a really hard therapeutic massage by a little Greek guy who was physio for the local footy team!!! Brilliant!!!
Sounds interesting 🤪. I’ve always loved having massages and have had a few ‘unexpected’ experiences in far flung places. eg. being slapped hard on the butt by a very burly ‘lady’ in Sri Lanka, a Thai girl straddling my back, an African lady whose hands were so rough I was exfoliated at the same time as the massage😵💫. I’m a little nervous of getting a massage at the moment. The last one I had was in the Maldives last March and the over zealous therapist tore the supraspinatus tendon in my right shoulder resulting in 2 recent surgeries. I need to do my homework and find a good professional masseur rather than a therapist in a beauty salon.
I am so sorry to hear this. But, I have found travel to be a trigger for increased pain also. I have taken diclofenac in the past and it helps. However, read about it. I had no issues with it for over a year. Even a 25mg pill helped me. Of course, that is something to discuss with your doctor. Can take up to 150mgs per day, but never needed that much. Praying you find a solution. Worth checking out.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Splitting dose of prednisolone
Where do I go from here?
Reducing prednisolone dose
High dose Prednisolone and effects
split dose of prednisolone
