steroids after a fall…

[PamJCam]

hi, I had a fall a few days ago, nothing broken but as the days go on I’m extremely stiff and sore on my upper body. I’m especially bad at night when laying down and the pain is at it’s worse. I’m taking painkillers (co-codamol) that work for a while till they wear off….Would anyone know if increasing my steroids would help? I’m on 5.5 at the moment after nearly 7 years, the lowest I’ve ever been and was doing really well till my fall… many thanks in advance

[PMRpro Ambassador]

Only one way to find out. If it is injury then it probably won't help - but bear in mind that a fall can be enough to trigger a flare so be really aware of that possibility.

[PamJCam in reply to PMRpro]

Yes I think I will have to give it a go….just so annoying when I’d done so well…thought I might be coming to and end with taking them! Thank you for your advice.

[DorsetLady PMRGCAuk volunteer]

Do painkillers help? That would be my first option-but as PMRpro says beware a flare.

This contains info should that happen —

healthunlocked.com/pmrgcauk...

[PamJCam in reply to DorsetLady]

Yes they are working for several hours but then it’s back…terrible overnight when they have worn off…better once I’m up and moving about just very tired!! Thanks for your advice

[PMRpro Ambassador in reply to PamJCam]

Your painkillers shouldn't be allowed to wear off - you need regular doses that carry you through to the next dose. It is the way they are designed to work, preventing the pain starting up again means LESS medication in the end.

[PamJCam in reply to PMRpro]

That is very sensible advice! I am terrible for not taking medication till I absolutely have to but I will do as suggest, thank you!

[SheffieldJane]

I would, falls shock the system. Get better soon!

[PamJCam]

thank you!!

[Grammy80]

So sorry you fell~!! I fell in June this year and severed the humerus in my right arm and broke it in two at the ball joint in the shoulder and had complete shoulder replacement surgery. I, too, was at my lowest dose of pred in four years. My personal choice was not to increase my pred because I knew I'd have to taper again. I told the surgeon the pain medication wasn't working and he then prescribed Tramadol...that worked. Calling him may be worth a try.

No Dr. Grammy...just Grammy~hope your soreness leaves soon.❣️

[PamJCam in reply to Grammy80]

Poor you! You have been through the mill! Hope you are feeling better…luckily bounced well but the aftershock is what I’m suffering with now. I’m definitely going to take painkillers more regularly and see if that helps before I increase my steroids.

[Grammy80 in reply to PamJCam]

I'm back...took a while, but I made it and you will too. Pam, I've always been reluctant to take pain meds but I did. I also took them as prescribed, every six hours to keep ahead of the pain. I know, the aftershock is real...getting knocked off our pins tends to rattle us, but it will pass. Be good to yourself.❣️

[PamJCam in reply to Grammy80]

Thank you!❤️

[HeronNS]

Just wondering if there is something about your body position when you're lying down? Maybe a few strategic pillows to keep your body aligned, or helping to alleviate pressure on the most painful places?

Lately have seen ads for Ibuprofen and Tylenol (paracetamol) combo in one pill so apparently they are safe to take together. Personally I've found taking aspirin and tylenol together gets rid of severe headache even better than when I used to take tylenol with codeine. I think there was more of a rebound with codeine so I'm not going to bother with it any more. Anyway it was getting too hard to find the very low dose tablets I kept on hand for rare use.

[Grammy80 in reply to HeronNS]

I wondered if you were still taking Prednisone, HeronNS. Any tablet with aspirin, especially Ibuprofen, is not recommended with steroids. NSAIDS... I have that red-flagged on my medical records as an allergy. I am allergic in a sense; my stomach will bleed.

I copied this from the web;

Don't take anti-inflammatory painkillers (NSAIDs) like aspirin, ibuprofen, or naproxen while you're taking prednisolone unless they've been prescribed by your doctor. This type of painkiller may increase the risk of side effects on the gut, such as stomach ulceration and bleeding.

Hopefully, you aren't taking steroids anymore and this was totally unnecessary. ❣️

[PamJCam in reply to Grammy80]

Thank you that’s confirming what I thought re ibuprofen and I can’t take aspirin so I’m sticking to the ones I know are ok.

[HeronNS in reply to Grammy80]

I'm taking 1/2 mg pred for a couple of days, then a zero day. I have taken aspirin occasionally throughout my PMR/pred journey, but always very carefully. Unfortunately acetaminophen is not on its own effective in treating my headaches. Except for a very small dose of codeine with tylenol or aspirin (and aspirin was always much more effective, I very seldom added the non-prescription codeine which I had to buy as part of a pill containing acetaminophen) I was not interested in taking any opioids. Fortunately I don't get headaches as often as I used to, but when I do they can be quite hard to get rid of and very debilitating. See my reply to PamJCam.

[Grammy80 in reply to HeronNS]

That is great, down to 1/2 mg every few days. So glad you are doing so well.💞

[KerryIreland in reply to Grammy80]

I didn’t know about pred and aspirin…I’ve been taking a small dose of aspirin (7mg) daily for about a year since an episode of high blood pressure and I’m on 1.75 pred. I have recently had a few stomach problems which I am coping with but now wonder whether at these levels the aspirin could be causing them?

[Grammy80 in reply to KerryIreland]

Try taking Tylenol...I know the relief doesn't last as long.....and see how your stomach reacts. Also, make sure you have some crackers or milk to soak up that stomach acid. I know, we are caught between a rock and a hard place. Be well💞

[KerryIreland in reply to Grammy80]

thanks Grammy 80, I take the aspirin as a blood thinner and I’m not sure whether Tylenol, or paracetamol as I’m in England, would do the same job. but I’ll make sure to have milk or yoghurt when I take the aspirin at lunchtime. Thanks for your reply and Happy Christmas.🎄🎄

[Grammy80 in reply to KerryIreland]

I think you best listen to your doctor! I hope your holiday was happy.💕

[PamJCam in reply to Grammy80]

👍❤️👍

[PamJCam in reply to HeronNS]

I read somewhere not to take Ibuprofen with steroids so I’m solpadeine plus and co-codamol alternately ….both of which say don’t use for more than 3 days!😩 and yes I’ve been pillows in various places to prop me up! Thank you!

[HeronNS in reply to PamJCam]

Yes you are quite right. I'm always very careful when I take aspirin. I don't take ibuprofen because of family history of brain haemorrhage. Aspirin is worse for the stomach but ibuprofen more implicated in stroke - I choose my poison! I never take it close to the time of pred, even though my pred dose is now very low. And always have food with any of these medications. I've occasionally used a low dose of codeine (8 mg) for many years to help boost aspirin because I've had some killer migraines. But now that I've managed without for about a year it seems that tylenol has a better effect in boosting the positive effects of aspirin and I've been able to take far less aspirin. Tylenol on its own is kind of useless so I have to say this effect surprised me, I was very skeptical until I tried it.

[PamJCam in reply to HeronNS]

Very interesting, you are like me in not mixing the different drugs together and having food when possible. Thanks for your thoughts.

[HeronNS in reply to PamJCam]

I hope you're starting to feel better.

[random901]

Hi PamJCam. I've had a few bad falls with lots of bruising and pain. Keep taking the painkillers regularly as Grammy80 says. I have an emergency supply of codeine which I alternate with paracetamol (can't take ibuprofen). Can't get into bath unless someone on hand to help, but when I can safely do so some epsom salts in quite hot water helps. As does arnica.

[PamJCam in reply to random901]

Yes I was thinking about a nice warm bath with some salts, luckily my husband can help out when needed! Thanks for all your ideas, so nice to know there are people out there in similar circumstances❤️

[Washbrook]

I stupidly fell recently too and broke a couple of ribs. Due to previous fragility fractures throughout my spine was admitted to hospital for a few days where they put me on Tramadol which was a godsend. I’m now off it (couldn’t wait!) and just taking paracetemol - four doses a day. I leave the last dose til as late as poss to help get me thru the night. I hate taking medication but taking it regularly really is helping.

I am aware of getting a flare, but do not want to increase my now low pred dose unless I absolutely have to - it’s such hard work reducing all over again. However if it becomes obvious my pains are a potential PMR/GCA flare, and not my injuries or osteoporosis, I won’t hesitate to increase the dose to nip it in the bud.

Hope your injuries heal soon.

[PamJCam in reply to Washbrook]

We have fairly similar stories but I luckily haven’t broken anything🤞 someone suggested keeping the painkillers going rather than stopping which I have done last night and today and it is definitely helping! I hate taking them but they are doing their job! And at the moment I’m keeping my steroids as they were nice and low! Thank you for your thoughts.

[Boss302Fan]

I wouldn’t be so quick to increase the Pred., take your pain medicine as instructed. PMR pain feels different than other, at least I could tell the difference. If you denote a flare starting in the muscle groups affected by PMR, then bump it up. That’s one recommendation I ignored and glad I did. I did not increase my Pred when I came down with a cold, not after I pushed myself past where I felt I should, and definitely not before taking a vaccine. Instead I waited to see what happened, being a little more diligent in paying attention for an onset of a flare. While I was not hesitant to increase my Pred dose when I had PMR pain, I didn’t just take it due to a maybe I’ll have a flare.

[PamJCam in reply to Boss302Fan]

Yes you are right not to rush, I’m definitely feeling better for taking the painkillers regularly and not touching my steroids. Many thanks.

[iblue]

Usually the 3rd day after an injury is the most painful. Taking non-steroidal medication consistently is important because (1) it reduces the swelling allowing the body to heal itself more efficiently and (2) it reduces the pain so that you can rest and not be overly stressed (which interferes with your body’s ability to heal). If the pain medication isn’t working you may not be taking it correctly. I wouldn’t jump to taking a higher dose of Prednisone, your tapering from it has gone so well. Taking the pain medication more effectively may be all that’s needed. Hope you feel better day by day.

[PamJCam in reply to iblue]

Thank you, everyone is being so helpful and supportive. Very glad I left my steroids as they were and I’m definitely feeling better today.