pain from fractures or pmr joining the party?

[Japsquar]

have been trying to judge whether pain and weakness in upper arms is a knock on from the fractured vertebrae (t9 and L3) or is it pmr creeping in. Very reluctant to up pred but don’t want to get into PmrPro’s bucket syndrome either! So, help! Would 3 days at higher dose be long enough to test that and to clear out inflammation?

[DorsetLady PMRGCAuk volunteer]

Doubt 3 days will be enough to clear out built up inflammation from PMR if that’s what it is - usual recommendation is at least a week - see here -

healthunlocked.com/pmrgcauk...

[Japsquar in reply to DorsetLady]

Thank you. Probably long enough to see if that’s the problem and if it is stay there longer, a week at least you suggest. Will go with that

[PMRpro Ambassador]

Possibly not long enough but you can try it and see,

[PMRpro Ambassador]

Now I have had time to look it up. I find it difficult to imagine that T9 and L3 problems could result in upper arm problems - they are both far too low down to supply areas that high. T9 might cause kidney pain - and affect the adrenals, L3 is the upper leg, hip to knee.

So I fear PMR is more likely! What dose of pred are you on?

[Japsquar in reply to PMRpro]

My thoughts too! But almost hoping with the voice of my rheumy in my head (you must reduce)! I was on 17-5 for some time but upped to 25 to cope with fallout from a wound and big family issue. Was about to go back down, but since the arm pain I've gone up to 30 (yikes) for the last two days and I notice today the arms are quite a bit better. So it does look like PMR. Another clue has been frosty and tender scalp on one side at night - a reminder of GCA symptoms which tends to occur when the dose is too low. Should I stay at 30 for a week do you think? will that be enough? Dont want to yo-yo. Meanwhile pain around the waist making walking difficult, that would be the L3.

[PMRpro Ambassador in reply to Japsquar]

Think someone needs to get a bit of a detective hat on. If you are needing that much it does raise questions as to whether it is rather more than "just" a bit of PMR? Is your "PMR" actually LVV affecting the subclavian or brachial arteries?

The subclavian artery supplies upper arms and contributes to the supply to the head and neck. If it were affected - or you had a subclavian stenosis or subclavian steal syndrome going on - it could account for the symptoms.

[Japsquar in reply to PMRpro]

This is new territory! And a new set of terms. I take your point and thank you for raising the possibility., a serious concern. But reading about it, I’m not recognising my experience. Even so I think I should mention it in phone call to Rheumy at the end of the month. I hope I can get her off the current obsession with osteoporosis and biphosphonates long enough to discuss the original condition!