Is this my PMR?

[Achyjoints]

Hello all, I am a male 60yrs of age and was diagnosed with PMR on Xmas day 2020. I have never got below 5mgs and have just reduced to 6mgs.Around last Oct/Nov last year having been diagnosed as having osteoporosis following a dexa scan, I was aware that my upper spine started to feel bruised when lying on a firm surface.

As I got into 2023 it started to get worse to the point that when sleeping I would wake early around 5-6am with the muscles on either side of my upper spine really aching/painful.

I have tried sleeping on all types of mattress but it has made no difference.

So my daily routine is, I wake up around 5-6am (sometimes earlier)with my upper back stiff as a board/painful and during the course of the day it slowly relaxes and I can function okay by midday as it slowly aches less and by the time I go to bed it feels much improved. I then go to bed and the whole process starts again.

I was convinced this was not PMR as it is not in my legs, hips or shoulders which currently feel okay, but it has dawned on me that it is getting worse as I start to get lower on my pred.

I have seen my GP twice, three osteopaths and a masseur but it has made no difference.

So I was wondering if anyone else has experienced this and whether it is my PMR?

Thanks John

[PMRpro Ambassador]

The pain waking you is rather late in the night for my first thought of ankylosing spondylitis and it also usually starts in the lower back. However - I think referral for an MRI to be sure would be a good move, There is something going on and it shouldn't be ignored. If it is AS, it is unlikely to show up on a plain x-ray. Does a good dose of an NSAID (800mg ibuprofen for example) help the pain?

[Achyjoints in reply to PMRpro]

Thanks for your response, funnily enough I saw my Rheumatologist today who I really dislike but she has referred me for an MRI, she had no real idea what it could be.The problem with taking a painkiller at bedtime is that I'm not really in much pain by then and I can't imagine it being effective throughout the night and stop me waking up in pain?

John

[PMRpro Ambassador in reply to Achyjoints]

The idea is to prevent the pain starting in the first place - you shouldn't wait for pain to take avoiding action.

[Flutterbies57 in reply to PMRpro]

Hmmmm , I didn’t realise that ! Thanks for your comment !

[Jakey2020]

I was only on pred eight weeks while Methotrexate kicked in.. the pain has eased but tired and no appetite!!! It’s certainly tried my patience!!! Jakey2020

[PMR2011]

it sounds a lot like my husbands osteoarthritis. He wakes up with stiff painful back. Once he moves about, stretches and sits upright a bit it improves. He takes Tylenol before bed which has helped. Hope you figure out what it is.

[Achyjoints in reply to PMR2011]

Thanks very much for that suggestion