Is this a flare? Pain on only one side.

[emmamom]

I have had PMR for 3 years. I recently got down to 7 mg a day and was doing great. (I am also on Actemra.) About a month ago, the pain started again in both hips and both sides of the groin. I increased by 5 mg for a few days and it got much better. I was tapering back down and then I pulled a muscle in my right back and then pain in my right groin got much worse, but only on the right side. My back is fine now but the pain in my right groin is horrible--like PMR. Could I have it only on one side and just have to increase again to control it? How do I know if it is PMR and not something else? Like bursitis or something?

[DorsetLady PMRGCAuk volunteer]

You’ve probably answered yourself….pulled muscle. Have you tried painkillers - paracetamol based not ibuprofen (unless it’s a one-flooding dose), warmth.

[emmamom in reply to DorsetLady]

I have tried Tylenol (no help), Tramadol (helps somewhat), and muscle relaxer when first pulled back muscle (helped somewhat). Have used heat and cold (initially). Thanks for quick reply.

[DorsetLady PMRGCAuk volunteer in reply to emmamom]

s’okay…..could be bursitis, but as you have recently flared, might be PMR as well… an extra mgs or 2 may help.,

[PMRpro Ambassador]

Having similar problems myself, I would suspect myofascial pain syndrome (MPS), specifically involving the piriformis and contributing to greater trochanteric pain syndrome! Eeeehh - sounds good put like that!!!

MPS is thought by some experts to be part of the underlying pathology of PMR but I find that part of it doesn't respond too well to oral pred - except by adding lots. Well placed steroid shots do and so does extracorporeal shockwave therapy and appropriate physio. It also still happens despite Actemra.

In extremis, I take a flooding dose of 800mg ibuprofen and sit with heat over the really sore bits. It can take a day or two to subside sometimes. My rheumy offers neural therapy - and I think that is available in the USA in places.

[emmamom in reply to PMRpro]

THANK YOU SO MUCH! THIS IS SO HELPFUL!!!!!

[Happyexplorer]

Hi Emmamom, I've come to this a bit late, but found it very interesting as I have exactly the same thing and am on Actemra and now 5.5mg pred! I decided to put up with the PMR in my hips as it's fairly mild and dissipates once I'm up and about, and haven't increased the pred as long as my GCA symptoms don't return. Regarding the one sided hip pain, I find stretching exercises that stretch out the piriformis muscle helps alot. I also felt my pain was aggravated by too much sitting and an electronic massager on that side also helped. If painful at night/ early hours when prednisone is nearly due, I've resorted to 200mg ibuprofen which might not be enough for a regular user, but I'm on anticoagulants so keep pain meds to a minimum. In a nutshell, muscle stretching is my remedy. Sorry, that's not a bit scientific like DL and PMRPro, but it's my experience, so thought it worth sharing. Good luck anyway, I feel we're coming up to the home straight and 2023 will be a much better year!🤞🤞🥳

[PMRpro Ambassador in reply to Happyexplorer]

May not be scientifically expressed - but it says it all

[emmamom in reply to Happyexplorer]

THANK YOU SO MUCH! It's validating to have someone else understand and have found something that helps!

[Happyexplorer in reply to emmamom]

Thanks Emma, 🤗 Altho I was thinking more, and on reflection, if it doesn't work for you, and if nothing else helps..... could it be something unrelated to PMR, like an inguinal hernia🤔? Maybe check with GP rather than suffering silently. Do hope it gets sorted!