Is it possible to relapse after 9 months of being well from PMR

[Littlejan22]

I had been diagnosed in September 2020, after 2 years of being on Pred it all stopped and I have been well without medication for 9 months, I have started to have the symptoms of PMR again, stiffness in the morning (to say the least) aching neck, sleeping for 2 hours every afternoon, I am due to go to the hospital again Wednesday, is this normal for it to come back, I have recently ended an extremely stressful job after 4 months of high stress levels, please help?😅

[piglette]

Sadly you are never cured of PMR, it goes into remission and every so often raises its ugly head again. Could you try taking steroids for a week or so and seeing if they help? If they don’t the problem may be something else.

[DorsetLady PMRGCAuk volunteer]

Unfortunately it is - and there are a few on here that do…. between 3 to 6 months after last Pred dose seems quite common.

The fact that you have been in a stressful job recently probably hasn’t helped, but 2 years on medication is quite quick - the illness can last a lot longer.

When you say you are due to go to hospital on Wednesday - is that PMR related or for something else?

You may find a trial of Pred for a couple of weeks confirms whether it is a reoccurrence of PMR.

[Littlejan22 in reply to DorsetLady]

Yes it is PMR consultant. Taken 15 mg today of Pred

[DorsetLady PMRGCAuk volunteer in reply to Littlejan22]

Hope it’s successful -please let us know how you get on…

[PMRpro Ambassador]

It isn't normal no - but it isn't uncommon. We think what may have happened is that the underlying cause of the PMR symptoms is still active at a very low level and even a very low dose of pred is enough to manage it. Zero pred allows the inflammation to build up slowly over time until it is enough to cause symptoms again. I think that the activity in PMR waxes and wanes, if you plotted it on a graph it would look like waves and sometimes you get to zero while it is having an extra quiet period but then it wakes up again - maybe you were stressed for some reason, were ill, and the immune system stamps its foot again.

It often means that if you catch it quickly you get away with maybe 5mg for a week or two and then can drop quickly to 2mg and then taper extra slowly again - you don't have to start all over again.