Prednisone

[Joseph14612]

So, I posted earlier about my ruptured achilles tendon...now I find out that prednisone weakens so many things and now tendons. I am wondering if it will even heal on prednisone...Any suggestions out there?... I told my wife, I would rather be in a wheelchair than blind.

[PMRpro Ambassador]

I have had achilles tendinitis twice - it took time, but it did heal eventually but it wasn't ruptured. I take it yours is a partial tear, not total? What have the doctors said?

[Joseph14612 in reply to PMRpro]

Only that it ruptured....I will have to ask..

[Joseph14612 in reply to PMRpro]

On second thought...she grabbed my calf muscle on my good leg and my limp foot pointed up...on my bad leg, it pointed down....she said this was an accurate test.

[PMRpro Ambassador in reply to Joseph14612]

New one on me! But accurate test for WHAT?

[Joseph14612 in reply to PMRpro]

A tear, but she didn't tell me to what extent...I will find out in 18 days ...it is 3-4 weeks with cast, and then a boot.

[Suedeshayes in reply to Joseph14612]

Hi. I ruptured my. Achilles tendon and had 3 weeks non weight bearing in a cast then 8-10 weeks with a boot. A ruptured tendon means totally torn, not partial. It is the conservative way of joining the tendon back together instead of stitching it in an operation. Mine is fine now, after following to the letter the physio excs I was given. Steroids weaken the muscles and tendons , which is in the tiny print in contre indications. It should be in large print, as people carry on through the pain with walking too much and continuing excs, when infact it’s needs rest. Good Luck. .

[Joseph14612 in reply to Suedeshayes]

Thank you… was the boot a walking boot?

[Suedeshayes in reply to Joseph14612]

Yes. Got so used to it I was scared to take it off. 🙄

It had graduated heel accessories and I used a lower one each week to have a slow stretch to the newly healed tendon.

[Joseph14612 in reply to Suedeshayes]

I would gladly take that over this cast...it is hot, itchy and miserable! Still have 2 more weeks...they said 3 weeks, but my appointment for removal is going to be 4 weeks.

[Karenjaninaz in reply to Joseph14612]

when I had a body cast as a kid I used a knitting needle top to scratch those itches. Back scratcher was too bulky.

[Joseph14612 in reply to Karenjaninaz]

Yep, trying all sorts of things...LOL

[PMRpro Ambassador in reply to Joseph14612]

Don't - if you break the skin and it gets infected it will be far far worse!

[PMRpro Ambassador in reply to Karenjaninaz]

Ooooh - naughty!!!!

[Karenjaninaz in reply to PMRpro]

Pro, I was in a cast after scoliosis surgery for 1 year at age 14. The itch was terrible . My shin was so thickened from not washing. Once in awhile my mom changed the stockinette lining. We had a phone support group in 1956-57 we all got the relief with a plastic, long, knitting needle blunt end.

[Joseph14612 in reply to Karenjaninaz]

Wow!!! That sounds horrible! 1 year? I doubt if I could do that and stay sane....you are a strong and disciplined person... A rare gem.

[Suedeshayes in reply to Joseph14612]

Yes, it is not pleasant. I had to be scanned after to make sure all was in place and tendon had sealed well. We are not much without our health. Hope the time passes quickly.

[singingloud in reply to Suedeshayes]

Last August I completely tore the tendon at the shoulder of my bicep. It will never heal. The muscle in that arm is disconnected and dropped. It still hurts when used in exercises in the pool. I still look like Poppi on one side. I count it up to the prednisone I have been on. Certainly being more careful with the other arm.

Hope your Achilles heals soon and well.

[Joseph14612 in reply to singingloud]

So sorry...😥 Prednisone can be so devastating, but still better than losing eyesight...

[Bridge31]

I had dreadful pain for several months with my Achilles tendon. Finally a visit to the podiatrist who organised custom built inserts for my shoes cured the problem.

[SnazzyD]

I think in these situations where it can go either way and you get good and bad stories, you have to plough your own furrow. People do heal on Pred as evidenced by operations they’ve had. Yes, tendons are tricky to heal but they can. I couldn’t walk without crippling pain due to Achilles tendinopathy when under 10mg somewhere and had in my fingers, neck and lower arms too. It lasted 18 months in all. This was the second time, first being due to Quinolone antibiotics over 10 years previously. Physio exercise sheets were useless and I faffed about with those for nearly a year. What made a huge difference were a podiatrist and a pelvic physio specialist (another issue) who both recognised my abdominal and hip weakness and gait were causing an abusive force on my already Pred weakened Achilles tendons. I had also been wearing flip-flops and slippers in the house all day every day; I am now banned from those. They prescribed specific exercises and orthotics in my shoes. It was a revelation. I am now ok for the second time. Time will tell for you but once out the other side of the dreaded boot, I would look at what your musculoskeletal system needs so you don’t give your Achilles tendons more than they want to deal with. It’s a grim thing to have to deal with I know.

[Joseph14612 in reply to SnazzyD]

Thank you, I will have to ask the Podiatrist....I did have inserts for plantar fasciitis years ago and they worked like a miracle....I don't use them anymore but I still have them.

[PMRpro Ambassador]

I have custom made orthotics too - recommended by the rehab chap as essential with achilles problems. It has taken time but it seems to have worked.

[Joseph14612 in reply to PMRpro]

Thank you, will have to get them out...

[Stills]

although I have not taken steroids since my mid 20s and I’m now 61 I ruptured three muscles in my lower leg. I didn’t get treatment due to the pandemic until a year later. It was a grade 3 rupture of the soleus and gastrocnemius with a tear in the heel tendon , I already had tendinitis from a previous injury. After two years of doing physio exercises and swimming the limp is hardly noticeable however it hurts all the time, I can only wear low rigid sole wedge shoes and still need the ankle brace if walking more than 1O minutes or so and can only drive my (manual) car for 45 minutes. Swimming did more good than the exercises I think. Hope yours recovers soon.

[papadapadoo]

Following a total achilles rupture 7 years ago and the operation + long long healing period, when I felt pain in the other achilles I started wearing a strong brace. I was very careful for a few weeks. About 6 weeks later it felt almost back to normal. We have to be very careful as we are not used to the havoc prednisone can wreak while it is helping us deal with PMR.

[Joseph14612 in reply to papadapadoo]

Thank you Papadaoo...after the cast is removed they want me to wear a boot... is that what you mean by a brace?

[papadapadoo in reply to Joseph14612]

Ah, no. After my surgery the first time, I had a splint for 2 weeks, then a cast for a month, THEN a boot. But this time I caught the achilles pain BEFORE the tendon ripped and supported it by taking it easy, and wearing a stretchable nylon brace to give support. That seems to have worked, at least for now. Did you have surgery?

[Joseph14612 in reply to papadapadoo]

No, they don't want to do surgery...they claim that over half of doctors prefer to avoid surgery...especially people like me who are on prednisone, plavix, etc. They also claim that non invasive treatment works just as well...I'm not sure I agree, but it is what it is...I might need surgery down the road.

[PMRpro Ambassador in reply to Joseph14612]

I had a totally torn medial collateral ligament (inside of knee) which was braced with minimal bend for 4 weeks and then the bend was increased. It healed perfectly - faster than the orthopod expected - and I have had no problems since. I must have been on over 10mg pred at the time. HIs SIL had had the same injury and her husband had arranged an op in a top Innsbruck clinic, It didn't work entirely so a second surgery was required and then she developed an infection, meaning a third op. The clinical studies show that at 18 months the results are similar - without the risks of surgery and an anaesthetic.

[Joseph14612 in reply to PMRpro]

Thank you for this encouraging info! God bless you!

[Joseph14612]

Yes...that is similar to what she did...but I had movement in both feet...so it might not be a total tear! the difference was which way the toes pointed when she squeezed the calf. The good foot, toes flexed upward...the bad foot, the toes pointed downward. First time I have seen this too. Thank you!

[papadapadoo]

My "total tear" came in three stages, separated by weeks. Each time, a flash of fiery pain, but the third time the tendon had rolled up like a windowshade. I had tried to be careful, but failed. In retrospect, I should have a had a boot on after the first partial tear, which came from running on a sand beach. I blew it by not seeking help immediately.

[Joseph14612 in reply to papadapadoo]

Thank you for that insight...it will be interesting, the next few months...I will be happy just to be able to walk normally...I won't be running...LOL

[papadapadoo]

My surgeon had to take a tendon from my foot to use as a splice. Not normal afterwards but I can walk just fine.

[Clucket]

Does anyone know if there is a pred dose below which muscles and tendon s are not weakened.

[PMRpro Ambassador in reply to Clucket]

Unlikely - it is more the long term effect and everyone is different. I would say pred hasn't had that great an effect, more the long term effect of a chronic condition that restricts exercise. And I have had PMR a long time and taken a LOT of pred