Flare

[Larabobara]

I had been doing so well, tapering slowly and had been comfortable at 4mg for 2 months. I was just about to go to 3.5mg when I had the most awful flare. Pain suddenly came on, almost as bad as pre diagnosis. Following the advice I have seen here, I immediately added 5mg to the dose, and have now taken 9md per day for 6 days. I'm afraid I am still in great pain. I cannot attribute this flare to anything. Should I up the dose again ?

[PMRpro Ambassador]

Are you SURE it is PMR flaring? Or could it be myofascial pain syndrome - which tends to affect lower back and spread to upper back, It CAN be part of PMR but it doesn't respond to pred in quite the same way.

[Larabobara in reply to PMRpro]

Thank you so much for your prompt reply. I'm not sure of anything. The symptoms of upper back and shoulder pain that I have, are just like my original pre diagnosis pain. But yes, my lower back hurts too. Do you think I have done the wrong thing in increasing the Pred dose ? What I haven't said is that I am in Europe with my husband. I am able to rest as much as I need to. We are away for several weeks and I brought plenty of the steroids with me. How would I treat myofascial pain syndrome ? I also have some co-codamol with me. I have not ever needed to take them but have them just in case.

[PMRpro Ambassador in reply to Larabobara]

Ho hum!!!! Which makes me wonder if it is the flight and the change of beds/pillows and all the rest of it! Do you have any pain radiating anywhere - legs, ribs, anywhere else? I don't think it was wrong to increase the dose but it does sound as if it isn't doing much.

My go-to for low back pain is an 800mg flooding dose of ibuprofen and a hot water bottle over the area in the low back that hurts. It may take a few hours but for me it usually makes a big difference. Then you can work out what else is what.

Where in Europe are you? Are you in the same place for a while or travelling around?

[Larabobara in reply to PMRpro]

I thank you so much for your interest and concern. We are in Croatia. We come here in our superb motorhome every year, a comfortable week long journey, then 4 weeks at one place, and a week traveling home. No flying involved. We swim, cycle, paddleboard and read, but gently. The flu jab that started all this, in Prof Garton's opinion was a few days after our return in Oct 2021. Last year, when I was at around 6mg, the trip did me the world of good. My own lovely bed and bedding, relaxing in this lovely place. This is why I am so perplexed as to where this has come from, snd what this awful pain is. We do have plenty of Ibuprofen with us, my husband occasionally uses it. The lower back is the least painful. My upper back and shoulders are by far the worst. An odd thing, the third finger of my right hand is hugely swollen and won't bend.

[PMRpro Ambassador in reply to Larabobara]

Oh right - yes, that is what I liked about our caravans/campervan, my bed, know whose been in it!! I get delivery of a VW California in a week or two, not quite a motorhome but there's only me and I will have the same freedom.

Hmm - don't know a lot about Croatian medical care - but the swollen finger is a bit concerning. Is it really just the third finger - not the little finger as well?

[Larabobara in reply to PMRpro]

No, just the third finger. Enjoy your California.

[PMRpro Ambassador in reply to Larabobara]

Might even make it to Pula again! Long time ago - when the girls were small.

[DorsetLady PMRGCAuk volunteer]

I wouldn't increase any more but you can stay at higher dose for up to 14 days, and then if no better drop back down to previous dose without causing an issue.

PMRpro has given advice on ibuprofen and MPS...

[Larabobara]

Thank you. I will give it a few more days at 9mg and see how I go.

[piglette]

Try a pain killer and see if that helps. If it does it may not be the PMR.