Calf Muscle Pain

[MegfromOz]

Hi everybody

I have a question re calf muscle pain

My history

- diagnosed with PMR & RA in April 23

- started 30 mg pred

- tapered to 10.5 in August

- experienced pain in buttocks, extreme fatigue and pain in left calf muscle

- Rhumetologist put me back to 12.5 pred for 3 months as I’m travelling

- still feeling dreadful so I upped to 15 pred last week

- contracted COVID last week

- am feeling ok with COVID, not on my lungs but still feeling left calf muscle pain and struggling with walking

- when I was first diagnosed I had extreme inflammation in my right knee as well as bilateral in hips and upper arms

Question

Have others experienced calf muscle pain,? It is not the result of any exercise.

Any solutions?

Thanks

[MegfromOz]

should add the pain is a dull ache and ongoing but not extreme even when lying down, doesn’t go away after rest and is worse after walking 250 m

[PMRpro Ambassador]

Have you spoken to your GP and told them the symptoms? The fact it is worse after walking a short distance suggest it COULD be claudication and that it is always there suggests if it is, then it is advanced comprise of blood flow in the calf. At some point the underlying cause of claudication is sufficienctly developed to mean that the blood flow to the muscles is so poor that it is painful even at rest and so there is ongoing discomfort. Walking makes it even worse.

It may not be, but you should speak to the GP or even the practice nurse who can check the pulses in the ankle and compare BP in the ankle with that in the upper arm. The ratio should be one, anything much below one needs looking into. Then you should be referred to your regional vascular services unit where they can do more testing.

[Daffodilia]

I have pain and burning in calves - assume part of PMR

[TJ70]

Hi

I had the same in both calves-went to AandE as Consultant thought it could be blood clots- after investigation turned out to be PMR- upped Pred for a week and it was sorted

[Gaycreasey]

Hello MegfromOz. My leg pain started in 2016 just before I was diagnosed with pmr. Walking up hill made my calves burn and hurt. It’s been on and off ever since. I’ve had a doppla test, seen a vascular consultant and a podiatrist. My legs are now very weak and I cannot walk very far without having to rest. The weakness I believe is due to anaemia which has just been diagnosed but the pain is also still there if I push my legs by carrying on walking. I am convinced that the pain is due to pmr. I am taking 3 mgs at the moment. Putting up the dose doesn’t make any difference to the leg pain. Sorry this is happening to you whilst you are travelling.

[Bramble2000]

Yes, absolutely ! It’s definitely one of my biggest PMR symptoms.

[MegfromOz in reply to Bramble2000]

Is yours bilateral? Mine is only my left leg. Was initially in my knee when first diagnosed but that settled once on pred. This is not settling. It started when I tapered to 11 pred so went back to 12.5 after seeing Rhumetologist 4 weeks later. so I think I was too low for too long. Now on 15 pred but no improvement. Appreciate any suggestions

[Bramble2000 in reply to MegfromOz]

Yes, bilateral

[MegfromOz]

thanks everyone for your wonderful support. The good news is I don’t have a blood clot. Got to experience all the glory of the New York medical system yesterday and ended up in ER. They were wonderful and luckily I wasn’t admitted. Seeming like this is a flare. Bloody complicated disease! The support from this group is outstanding

[DorsetLady PMRGCAuk volunteer in reply to MegfromOz]

Good news it’s not a blood clot…. And glad you got it sorted out.. what are you doing to address flare, if that’s what’s suspected?

Edit - just seen your reply - usual advice for dealing with flare is in this link -

healthunlocked.com/pmrgcauk...

[MegfromOz in reply to DorsetLady]

Thanks, I’m not sure if I’m doing the right thing and my rheumatologist was pretty nonplussed when I saw her late august. I was reducing by 1 mg per week, although she told me 2 1/2 per week. I got to 11 and calf muscle began hurting, new symptom.

I should have gone straight back up with the pred but I waited a fortnight to see her, she put me back to 12-5 and told me to stay at that dosage while travelling for two months.

Last week I upped to 15 coz my leg was preventing from walking anywhere. Should I up the prednisone again?

Also, had COVID last week.

Not sure if I should organise a phone consult with her. It will put me out of pocket about $500. Thoughts?

[DorsetLady PMRGCAuk volunteer in reply to MegfromOz]

I’d be inclined to treat as a flare [as described in link] adding 5mg to dose you last felt good - can remember what that was? If it was 12.5mg, then try 17.5mg for 7-10 days and then down 12.5mg. If it was 15mg, then up to 20mg.

Covid probably will not have helped, but I have to ask why you were reducing so quickly… every week is much much too fast [even at 1mg] you are never sure whether current dose is enough before you drop… and 2.5mg is absolutely bonkers.

See if the above works, if it doesn’t then you will need to speak to Rheumy [sorry!].

[MegfromOz in reply to DorsetLady]

Oops, it was every fortnight decrease of pred and I changed so it was by 1 mg rather than 2.5

[DorsetLady PMRGCAuk volunteer in reply to MegfromOz]

Even every 2 weeks is a bit quick - it can take that long for a flare to appear...

[PMRpro Ambassador in reply to MegfromOz]

"I was reducing by 1 mg per week, although she told me 2 1/2 per week"

WHAT? That is ridiculous, you only use that sort ot reduction to get off pred - not to titrate the dose in a chronic illness like PMR. Really wouldn't want to be wasting $500 on her opinion - but you do need a better doctor who knows what they are about as you do need medical advice.

What are you on for the RA? Why does she think it is both RA and PMR?