I have recently been diagnosed with PMR. High CRP (65), badly swollen hand and shoulder pain/winged scapula.
Whilst waiting for an official diagnosis I was taking Naproxen for the pain which gave me some relief. As I had responded relatively well to Naproxen the rheumatologist said he would try me with a one-off injection of Depo-Medrone 120 to see how I got on for a couple of months and then review to see whether or not I needed oral steroids. He hoped that, by giving me a break from my symptoms, I might start to recover.
This suits me perfectly, I don't really want to be taking oral steroids if I can avoid them. But how long does the effect of the injection last? It has been a week now and I can feel some of the symptoms returning. I am wondering whether or not to take some Naproxen again or is that going to interfere with the hoped-for effect of the Depo-Medrone? At the moment I am fine, just a bit achy, the jab has worked wonders for all the little pains, it is the big ones that are starting to return. Has anyone else been in this position?
But how long does the effect of the injection last?
Bit of a 'how long is a piece of string' question - probably depends on how much your inflammation has built up.
My GP 'thought' my GCA was a frozen shoulder, so gave my cortisol injections - 3 in fact over a 12 month period. Don't think any of them lasted very long, obviously decreasing in pain control as the time went by.
It may be helping your shoulder pain a little - but it doesn't do much for PMR itself in other areas..
..and if Naproxan is helping then it's probably not all down to PMR...
Thanks for your reply. The Depo-Medrone wasn't injected into my shoulder, it was in my bum. It wasn't meant as localised pain control but as a shot of corticosteroid into the bloodstream. It has had a transformative effect and I no longer need to take Naproxen or anything else...yet. I am wondering how long I can expect to enjoy pain and inflammation relief before the effect of the shot wears off. I get a rheumatology review mid-January but, if I get significant pain/inflammation before then, I am wondering if I will be OK taking Naproxen again as it offered some, if not full, relief from pain/inflammation.
Mine lasted about 5 weeks. Felt like a new woman after 24 hours.
After 4 years I’ve just had another one and I would say a similar timescale although this one helped more with my energy levels than aches and weakness.
Hi Bridge31...thanks! Yes...it is something of an overnight "magic bullet" isn't it! I thought that 5 weeks might be the most that I could expect. The rheumatologist was hoping that, by giving me a break, my body might just learn to behave itself and I might not need to take oral steroids. Steroids are produced naturally in response to stress...so I believe. I might have to introduce some more stress into my daily life...perhaps I have become a little too laid-back!
Not the way it works unfortunately! Stress is one cause of the immune system going haywire and causing PMR symptoms. The depot-medrone deep i.m. injections are a recognised management for PMR with injections administered once a month initially. But as the amount released falls off, the daily dose falls below the amount you need to manage the inflammation - and the symptoms reappear.
Krikey...that is complicated! But thanks for the link anyway...I will do my best to understand at least a little of the information. I have come to the end of my "honeymoon period" with Depo-Medrone and will be seeing my rheumatologist next week to get started on oral steroids and Methotrexate. I really like the man and so far I trust him 100%. For the time being I think I must rely on him to understand the complicated science and advise me accordingly.
I had the depo medrone in the bum last year, as GP thinks I have RA. It helped with other medical issues, but I was still taking oral steroids for PMR. The effect lasted two months for my Bursitis, sciatica, osteo arthritis, & other issues. I now have targeted steroid injections eg one two weeks ago for Bursitis, will have one in January, either OA thumbs or plantar fasciitis in heel. I can’t take naproxen or ibuprofen, but I was on Tramadol the whole time, & just changing over slowly to pain patches now the tranadol has ceased to work well. I see the Naproxen helped you. Dorset Lady will tell me if I’m wrong, but I don’t think it usually helps PMR at all. The only thing that does is oral steroids. Four years for me, but they enabled me to live a better life than I would have done without them!!
I agree with that, I realise I was on oral steroids, anyway, but at the time they were keeping my PMR under control. The injections were solely for other medical issues.
Hi...many thanks! I have read that Naproxen doesn't help PMR but my rheumatologist said that it can help some people, I am one of the lucky ones. It was only ever a stopgap for me but I would have struggled without it whilst waiting for diagnosis. It gave me stomach issues and it didn't last long enough to take me through the night, I would always have to get up at 4/5 AM and swallow enough Codeine to knock me out for another couple of hours...but at least I was getting a few hours rest...I wouldn't call it sleep! The steroid jab has, thankfully, solved all of that for the time being...but for how long?
The steroid jab has, thankfully, solved all of that for the time being...but for how long?
Unfortunately no one call tell you that… but will say that the injection is only acting a sticking plaster. Its effectiveness will inevitably reduce day by day.
Yes, always the 65 million dollar question! To be honest, I’ve had one last two months, & I had a guided steroid injection in hospital & that lasted 48 hours! For me, what also matters whether it’s done in winter or summer, too! The climate can help, or hinder! But that’s probably because some of my injections have been done in order to help worsening arthritis. I lived for 3 years with only 3 - 4 hours sleep a night, it really affects the whole of your life!
Um - your rheumy seems to have some VERY unusual views. One i,m, depot medrone is unlikely to "reset" PMR and as for Naproxen - it is NOT recommended for PMR and probably has enough nasty adverse effects to rank it in the direction of pred!!
Hi...the rheumatologist didn't prescribe Naproxen, my GP did. It was only prescribed as a short-term measure whilst I waited for a Rheumatologist appointment to become available. I have no problem with the rheumatologist's approach, he will be contacting me mid January and says that, if my symptoms return, he will prescribe Prednisolone. I don't want to be taking Prednisolone if I don't have to and am happy with the wait-and-see approach. At the moment I am feeling more-or-less OK...
Nobody wants to take Pred -but many need to, to get a reasonable quality of life… and “feeling more or less OK” suggests you could be better -just make sure it doesn’t deteriorate.
Many thanks...it is early days for me. More or less OK means that, although the inflammation seems to have abated, I am left with some muscle wastage which will need physiotherapy/exercise to repair. I am not opposed to taking Prednisolone if I need it, I can see how it is life-changing for many, but I don't need it at the moment...one step at a time...!
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Tapering advice please.
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Oral pred & steroid injection in joint
