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[inpainsotired]

Hi everyone, just joined.

After years of pain (on and off, here, there and everywhere!) my doctor sent me for x-rays, scans and no end of bloods May last year. I've had "flare ups" during the last 11 months but just recently they get more often and stay with me for longer. My doctor called me yesterday and told me I have PMR. I have been in paid the last 7 days. She has told me to take paracetamol and ibuprofen whilst she refers me to the rheumatology dept of local hospital. Firstly, I am angry with myself for feeling better and thinking I do not want to waste doctors time with what is probably to do with menopause and secondly the fact that paracetamol and ibuprofen just aren't touching this pain. Do I have to see a rheumatologist before I'm prescribed pred or can my doctor prescribe it ?

[PMRpro Ambassador]

Hi and welcome!

A GP can prescribe pred - but it sounds as if she doesn't really have the courage of her convictions. You may have a long wait for a specialist appointment in the current climate though. Is there another GP you can see? The fact ordinary painkillers aren't touching it supports the PMR diagnosis and there is no reasons why she couldn't do a trial of pred. If it is menopause then pred is less likely to help - but if it doesn't work after a few weeks you can just stop at that stage.

[piglette]

Could you convince your doctor to give you a trial of steroids for a week to see if they help??

[PRL1957]

My GP had diagnosed PMR based on my symptoms (pain, impaired mobility, raised inflammation markers) but also said that a rapid improvement on prednisolone provided further confirmation. (And I felt much better within 3 hours of taking my first 15 mg dose!)

Would your GP not prescribe prednisolone as a similar 'confirmatory test'?

[Bcol]

No problem with a GP prescribing Pred unless they think there are other major contributory problems. All my PMR care has been with a GP.

[Koalajane in reply to Bcol]

I have never seen a rheumatologist either. In fact a lot of my care is done by a nurse

[DorsetLady PMRGCAuk volunteer]

hi and welcome,

Won’t add anything re GP and prescribing Pred, but will say don’t be cross with yourself thinking it was menopause or not wanting to waste doctors time - many of us been there.

But if but is PMR [no comment about dithering GP] - have a look at this to give you a bit more info, and come back to us when you have a bit more news or need more help please -

healthunlocked.com/pmrgcauk...

[alangg]

I understand your anger and frustration; I went about 9 months with pain and increasing disablement before diagnosis, despite a private physiotherapist writing to my GP surgery early on telling them that she thought it was PMR!

Then a new, young GP prescribed 15mg Pred daily for a week saying that if the symptoms reduce significantly it probably is PMR and if they don't, it probably isn't and you can stop taking the pred (don't do that if you've been on it for longer though).

My symptoms went after about 4 hours! The GP referred me to a Rheumy who replied saying 'textbook case, treatment working, don't want to see him'! It took me nearly 3 years to reduce to zero but now it has all gone.

[Pass7 in reply to alangg]

by saying reduce to zero but now it has all gone. You are PMR & pred free? Congratulations

[alangg in reply to Pass7]

Yes - PMR free. But I am very aware that it might return so won't hesitate to go the GP and back on pred at the first symptoms.

[Body_bonkers]

I’ve just been in similar situation and blamed it on the perimenopause initially but GP had to refer me to rheumatology due to ‘young’ age. I was in dire straits (painkillers ineffective) so went private - thankfully it only cost £140 for one consultation to enable GP to prescribe steroids so don’t suffer if you can afford this. All my stiffness went in twelve hours and about 90% of the pain few days later. I was told you can just stop the steroids after a week which is hopefully enough time to confirm PMR diagnosis

[PMRpro Ambassador in reply to Body_bonkers]

How old ARE you? I've looked through all your posts but can't see an age.

[Body_bonkers in reply to PMRpro]

48 now but suspect symptoms started two years ago

[PMRpro Ambassador in reply to Body_bonkers]

The guidelines say over 50 - but that is not an exclusion of patients under 50. Prof Mackie says she has several patients who are in their 40s and the youngest patient in the literature was 24!

thefreelibrary.com/A+24-yea...

And for GCA, there is record of a 37 year old male in South Wales who had GCA. Absolutely certain - the pathologist found it after he died of a stroke after GCA was misdiagnosed. The pathologist always gets it right!

The ageism infuriates me!

[PMRfacebook]

I had a similar experience at similar age 55 and also blamed on menopause (very common apparently). My GP wouldn't diagnose and referred me to Rheumatology. The pain (and fear) got so bad I paid £200 and had private consultation with a Rheumatologist who then got the GP to prescribe steroids. Best 200 I ever spent

[Brooklyn747]

Your doctor can absolutely prescibe prednisone. In fact if the correct dose is taken and within a short period of time alleviates all pain then you definitely have p.m.r. By all means see a rhumatologist, but not completely necessary.

[PMRpro Ambassador in reply to Brooklyn747]

No, I have to correct that - it does not DEFINITELY mean it is PMR, other things respond to pred and not all PMR patients respond in a few days or to a 15mg dose but it does add to the balance of evidence for PMR.