A flare or something else

[MNgirl49]

I was diagnosed with PMR in August 2023, and was put on 20 mg prednisone. I've tapered down to 7.5 mg now.

A week ago, I snagged my right little toe on a chair leg. The toe turned purple and hurt a lot. Over a couple days, the bruising spread across the top of my foot. The pain in my foot has been manageable, and has subsided quite a lot. But now I'm having pain all the way up that leg, into my knee, thigh, low back and hip, and now my right shoulder and neck are hurting. Just on that side.

Is this a flare? I can't think of anything else that would cause this.

[PMRpro Ambassador]

Sounds as if you probably broke that toe! But no, that doesn't sound like a flare, it sounds like something related to that damaged toe although the spread all the way up the right side is strange. What is a possibility is that you have been walking "wrong" favouring that sore foot and putting stress onto all the back and leg muscles. Eventually they protest very loudly at the unfair treatment and go on strike.

Do you have a chiropractor near you?

[SnazzyD in reply to PMRpro]

Was going to say the same!

[SnazzyD in reply to SnazzyD]

Had something similar after I stubbed my toe and broke it just before a shift. Walking on the wonk put everything else out right up to my neck.

[MNgirl49 in reply to PMRpro]

Thanks, I have massage and chiro available nearby. It seems like an over-the-top response to a broken toe, but I'm happy to think it's not a flare.

[PMRpro Ambassador in reply to MNgirl49]

As both I and Snazzy have experienced - walking abnormally for whatever reason can result in quite severe back muscle problems,

[piglette]

Does not sound like PMR. Can you get your foot x-rayed?

[MNgirl49 in reply to piglette]

I could get an x-ray, but since the toe isn't primarily what's hurting right now, I'm content with a break or sprain that somehow generalized the pain in half of my body--which I find quite weird.

[paulus65]

Apart from the toe, your taper from 20mgs to 7.5 since August seems very fast.

There's a lot in this forum ref the need to taper sloooooowly.

[diana1998]

I did that and X-ray proved I'd dislocated my little toe. But the pain was excruciating. I had it put back under a local anaesthetic. Very sore afterwards and black and blue but I have to say I didn't have pmr then.

[Genesini]

A reduction from 20mg to 7mg since Aug, appears to be an unusual and very sharp reduction. Your GP may need to revisit your treatment. Therefore it could be a flare, in addition to the toe Inflammation?

[MNgirl49 in reply to Genesini]

I went to an orthopedist and had X-rays. He's familiar with PMR, and said my broken toe may well have caused a flare. Said I should up the dosage for a week and see if it helps. I have an appointment with my rheumatologist in 9 days, with blood work beforehand. I'm back up from 7.7 to 12.5 for a week, and we'll see what the bloodwork shows.