PMR or Ankylosing Spondylitis

[Freelabour]

PMR or Ankylosing Spondylitis

Hi. I was diagnosed in Sept 2023 with PMR. This was after many telephone consultations and each time having been prescribed with stronger pain killers, which didn't help. After 3 days on 15mg of Pred the pain and stiffness was 75% better. I am now down to 9mg and had intended to reduce by 10% per month.

Had an appointment with rheumatologist yesterday and after a discussion and looking at a 2021/2022 CT scan and an X-ray it was decided to have an MRI as “there’s a possibility I may have Ankylosing Spondylitis. I should have an appointment in 6 to 8 weeks and cut my Pred by 1mg every 2 weeks until I’m down to 5mg before the scan”

Having pain and stiffness starting in my groin and then down my left leg and then the same in my right a few days later, followed by my left shoulder a few days after that, also severe pain in thumps and wrists, apparently this is ”not necessarily symptoms of PMR” !!

So my question is, should I be tapering this fast?

I found this site a few months ago and have found it so informative, many thanks to all of you

[PMRpro Ambassador]

Well - no, if you were just tapering. But they need you on lower pred before the scan and it may be fairly soon so yes, you have to taper quite quickly.

You COULD have both PMR and AS of course so lowering the pred would hurt if you do. What painkillers didn't work? NSAIDs usually DO have an effect in AS.

I thought AS diagnoses were made on the basis of structural findings but when I looked it up, it is also looking for inflammation to confirm the diagnosis. And pred suppresses that - so you need to come off pred.

[Freelabour in reply to PMRpro]

Thank you for your quick reply.

So started on Naproxen, then Codeine, then Diazepam then Oramorph

The rheumatologist is looking for inflammation to confirm the diagnosis

Looks like I will have to take the hurt if necessary . Thank you again for your reply

[Amb1xkr in reply to Freelabour]

Exactly the same thing happened to me with the diagnosis. Had to reduce steroids every two weeks. Rheumatologist said all my pain would return before they could confirm ankylosing spondylitis as steroids were not the right treatment. I’m now on methotrexate and a Biologic. Hope you get to the bottom of it. Big hugs

[Freelabour in reply to Amb1xkr]

Hi Amb1xkr . Thanks for your reply,it’s really helpful to know this seems to be the right procedure . Not looking forward to the return of the pain, but if needs must.