How should I Feel

[Carathedog]

Hi,

I’m currently on 7.5 mg, have been for three weeks now, and intending to stay for another few weeks.

I take my pred at 2am. I sleep well, as I’m also on Pregabalin for Spinal Stenosis. When I waken about 8.30, I’m very sore, especially both buttocks, and both legs, especially right leg. I have slight pain in my shoulders. By about 11am, most of my pain has gone, still some in the buttocks. As the day progresses, I feel mostly pain free, maybe some small twinges. All in all I am coping.

I know you’re going to say there is no normal, but is this realistically how things progress. I am seeing my GP next week, he basically lets me manage my own medication. Do you think I should ask for some blood tests, to see where things are at.

Kind regards

[PMRpro Ambassador]

Have you had the buttock/leg pain al along? Is it because a bit more pred might help or is it due to the spinal stenosis? Could it be piriformis syndrome? Buttock pain is typical of that. Have you had blood tests before - do you know if the ESR and CRP compare with how you are feeling?

On the whole though, if you are happy and the pain isn't worsening it sounds not too bad,

[Carathedog in reply to PMRpro]

Thank you, I’ve had a couple of blood tests previously, my markers have always been normal.

Yes I’m finding it difficult to distinguish the pain between PMR and Spinal Stenosis, we’ll see what bloods come up with, will also ask for a cortisone test

[PMRpro Ambassador in reply to Carathedog]

"will also ask for a cortisone test"

What do you mean by that? Why?

If you mean a cortisol level or a synacthen test they won't provide a meaningful answer at 7.5mg pred -that is plenty to suppress adrenal function and you need to be under about 5mg to get anything of value.

[Carathedog in reply to PMRpro]

ok thanks

[SheffieldJane]

Have you ever had advice on your mattress and pillows? Just a thought. It sounds as if your morning is recovering from an uncomfortable night.

[Carathedog in reply to SheffieldJane]

No I sleep very soundly, no uncomfort thanks

[Bcol]

I guess one thought is have the pains got any worse since your last taper? If so it maybe you've gone a little too low. On the other hand the Pred may have been masking the pain from any previous conditions.

[HeronNS]

I was looking back at an earlier post and it seems there's always been a question whether your pain is due to PMR or to the spinal stenosis. Seems like best thing would be to hold steady at the 7.5 for now, as you have intended, and see if there is anything else you can do to alleviate the pain. Just because you sleep well and are comfortable as you lie there doesn't mean that something isn't being strained which you notice when you shift position to get up. I speak from experience as I have osteoarthritis as well as probably some faint traces still of PMR. Like you I take pred at 2 am and find this has worked very well. I also do a lot of physio-prescribed exercises to strengthen muscles as this actually helps the bones which the muscles support. I don't take any other prescribed medications although I do take glucosamine sulfate for the OA, and use Flexiseq (a non-medicated gel especially formulated to help with osteoarthritis) on my knees, hands and nowadays one of my feet. The arthritis in my cervical spine has sometimes caused referred pain in my shoulder, and this has been confused with PMR, or contrariwise, a PMR flare has been confused with OA. When different conditions cause similar symptoms there's nothing much we can do except experiment by treating one and if that doesn't work trying plan B. My usual thing is to try the non-pred option first, just because pred is, well, pred, and then if that isn't helping or matters are getting out of hand, increasing pred - and increasing it enough to return to my most painfree state which for all of us should be no less than 70% improvement of pain symptoms and for some is close to 100%. At least as close to the best level of relief provided by pred in the beginning.

[Carathedog in reply to HeronNS]

Thank you,sound advice, and interesting re sleeping position , maybe the Pregabalin, makes me sleep so soundly, I am straining something