Knee and Thigh pain

[daisylazy]

A question for all you wonderful experts. Out of the blue I developed soreness and stiffness in both knees and outside of left thigh. Painkillers and nsaids don't do anything for it. Sitting down fine but can't put much weight on them. Have app with doctor next week but in the meantime I wondered if you have any ideas. Before this happened I could walk a mile and a half. Thank you in advance.

[DorsetLady PMRGCAuk volunteer]

If painkillers and NSAIDs don’t help have you considered an extra mg or two of Pred to see if that helps? It may not, but worth a try before you see doctor.

What dose are you on now?

[daisylazy in reply to DorsetLady]

Thank you Dorset Lady. On 5mg at present. Didn't think of increasing pred. Will try that.

[DorsetLady PMRGCAuk volunteer in reply to daisylazy]

Worth a try- as it’s both knees and painkillers don’t help… if it does then at least you can tell doctor.

[daisylazy in reply to DorsetLady]

Thank youWill do.

[SnazzyD]

See if this rings any bells for you, Iliotibial band syndrome. You don’t have to be an athlete to get issues with this.

complete-physio.co.uk/iliot...

[PMRpro Ambassador in reply to SnazzyD]

I was thinking trochanteric bursitis too with the mention of outer thigh pain!!!

[daisylazy in reply to PMRpro]

Thanks Pro, trying a few different things and hopefully something will work until I see the doc.

[Pixix in reply to PMRpro]

I am, too…doesn’t quite describe mine, but has a lot of similarity!

[daisylazy in reply to SnazzyD]

Thank you Snazzy D could be as I had done extra walking days before.

[Janstr]

My pmr started with thigh pain

[PMRnewbie2017]

My dose is now 1.25mg, and out of the blue both knees are sore. My quads are now much weaker than they used to be due to not doing as much exercise. I think we have to hear in mind that we are ageing, our muscles deteriorate due to age and long term Pred usage and osteoarthritis is no longer disguised by Pred as we get to the low doses.I agree you need to get a diagnosis but on my journey below 5mg I could strain a ligament or pull a muscle so easily. Any injury I picked up took months and months to heal and often contributed to my inability to exercise, hence the loss of tone and muscle strength.

[daisylazy in reply to PMRnewbie2017]

Tha ks PMR newbie so true what you say.We forget that sometimes.

[marionofnorwich]

Yes, I think I would concur with PMRnewbie2017 . It may not be PMR but a consequence of PMR. All the way through I have found that my muscles fatigue and stiffen up so much more quickly so that 10 minutes of walking is equivalent to a couple of hours (and I can't walk much longer than that). For the first two years I could walk a mile of so but would really feel it the next day then Covid caused a real burst of inflammation which (I think) caused an inflamed ligament which is still healing 18 months later. Stiff quads and illiotibial band also a feature. It is hard to separate what is muscle tone and what is PMR but I am told by physios that my leg muscles are quite strong, but I think the quality of the muscle fibres and stretchy-ness is pretty bad. Ultrasound treatment and massage seem to help a lot

[Hoofprints in reply to marionofnorwich]

How does the ultrasound treatment help and do you get it on the NHS? I hope you continue to improve 🤞🏻

[marionofnorwich in reply to Hoofprints]

No, I go to a private physio. It is not like the ultrasound that gives an image but ultrasound therapy. You can also get home ultrasound gadgets. I use one of those occasionally that I borrow. It has helped various inflamed ligaments in the past too even before PMR. I think it works by stimulating circulation at a deeper level than massage alone sportsinjuryclinic.net/trea...

[Hoofprints in reply to marionofnorwich]

Thanks for explaining that . Sounds like a very useful addition to the treatment regime.

[daisylazy in reply to marionofnorwich]

Thanks Marion of Norwich.

[Woodly]

I have been told by the rheumatologist that I probably have Claudication which this explains:- "Claudication refers to muscle pain due to lack of oxygen that's triggered by activity and relieved by rest. Symptoms include the following: Pain, ache, discomfort or fatigue in muscles every time those muscles are used. Pain in the calves, thighs, buttocks, hips or feet" In my case it is caused, he says, by a spinal problem but can also be vascular. I have been taking prednisolone now for 7 years for GCA at varying doses determined by the blood test i have at regular intervals. i am assured the GCA is kept at bay but other problems arise for other reasons entirely.

[PMRpro Ambassador in reply to Woodly]

If it is - have you been investigated for peripheral vascular disease which is a late consequence of GCA and PMR and in some cases, things can be done to improve the symptoms.

[Woodly in reply to PMRpro]

i was told it arises due to age related spinal Stenosis (shown up by MRI) and not caused by a vascular problem but it is worth querying it so thank you. I only mentioned it beacuse so many conditions can be caused by factors unrelated to GCA and PMR and medications.

[kp60 in reply to PMRpro]

what is the method - ultrasound, and how far reaching does it need to be?

[PMRpro Ambassador in reply to kp60]

Method for what? Dealing with claudication? Not u/s no. It may be medication or surgery if it is vascular in origin.

[kp60 in reply to PMRpro]

I'm sorry I wasnt clear. I'm confused as to the methodology for diagnosing LVV.

[PMRpro Ambassador in reply to kp60]

If it is suspected, PET-CT is the best imaging modality. The ultrasound technique depends on a halo sign being identified in the artery wall or a change in compressibility of the artery - not entirely sure of the details there. The temporal artery is usually used as it is accessible. It can also be used on the subclavian and brachial arteries and if the signs are found in those arteries, it suggests there is vasculitis outside the cranium, so LVV. But not all hospitals have access to the ultrasound technique so it isn't always done routinely.

[kp60 in reply to PMRpro]

Thank you for that clarification

[Flutterbies57]

I was suffering this too for weeks . I did not realise it was PMR related . Someone suggested I go from 3.5 to 5mgs . By next day problems we’re gone , so I thought it must have been PMR related . I had a couple of good weeks however problems retu yesterday . I am really reluctant to go up again , but I don’t know what to do . I have no Dr support at mo . Should I rest up , stretch, gently excercise or go up ?

[PMRpro Ambassador in reply to Flutterbies57]

Prof Dasgupta told us he often kept patients at 2-3mg long term to reduce the risk of relapses. If you are on even a tiny bit too little and there is left-over inflammation, it will build up until you are back where you were at the start - and it needs more pred to sort it out, if indeed you can.