Relapse after two weeks on 15mg Preds

[Lassie2]

I started taking 15mg of Preds two weeks ago and within hours began to get instant relief apart from a slightly stiff right shoulder. At the same time I was given 50mg Diclofenac anti inflammatory drugs for a swollen arthritic knee

I stopped taking the Diclofenac two days ago for the knee and yesterday I stated to have pains in my lower abdomen

Do you think this is a coincidence or could there be some relationship between the two?

I thought I was doing so well so I am so disappointed to have a relapse so soon .

Is this to be expected ?

The doctor is planning to reduce my Preds to 12.5mg from next week so not sure what to do

Many thanks

[SnazzyD]

Hello there. Normally steroids should not given together with non-steroidal anti inflammatory meds because of the risk of irritation to the stomach as both do this. Occasional on-off doses are ok but not continuously. Normally doctors offer stomach protection medication along side Pred. Not everyone needs it but lots do.

When you say abdominal pain, where exactly do you mean? What sort of pain is it? Is there anything that makes it better or worse? Abdominal pain isn’t normally a symptom of PMR so it’s worth looking into what thus might be.

Normally Pred is not reduced until the PMR inflammation is controlled and often at the start it is held for 4-6 weeks.

It will really help those replying if you fill out your bio section with details like when you were diagnosed, what your symptoms were, what dose and other meds you were given and what your reduction plan has been.

[Lassie2 in reply to SnazzyD]

Details updated in bio section but diagnosed two weeks ago . Anti inflammatorys were prescribed for a couple of weeks to bring down severe swelling in knee and was also given Omeprazole gastro resistant tablets. Doctor also wants me to take a tablet once a week to protect bone density but haven’t stated .

Previously before Pred along with pain in shoulders ,arms ,hands , lower back , I had on and off lower abdominal / groin pain which made it very difficult to move. Incidentally doctor took blood on Wednesday and said blood now back to normal levels . Many thanks

[DorsetLady PMRGCAuk volunteer in reply to Lassie2]

Bone density tablet is Alendronic Acid, and bloods should be back in the normal range, just shows Pred is dampening down the inflammation.

Lower back and abdominal are not the most common symptoms of PMR, so there may be something else going on as well.. so think it needs to be checked.

As you are new, you might like to look at this info/intro post -

healthunlocked.com/pmrgcauk...

[DorsetLady PMRGCAuk volunteer]

As SnazzyD has said Pred and NSAIDs shouldn’t be prescribed together..

.. and as she has said abdominal pain isn’t usually associated with PMR as such -so do wonder if it’s a rebound reaction after stopping Diclofenac - although that seems slightly strange.

A bit more info on your bio would be helpful.

[SheffieldJane]

In my case my Diverticulitis seemed triggered during my taking Actemra period. The pain remains to this day, in attacks, and now if I take coated Pred without Lansoprazole the pain is much worse, I didn’t have any of these issues before and didn’t have to take a stomach protector. I took 1mg of uncoated Pred during a flare and sharp abdominal pains followed shortly afterwards. My condition was diagnosed by a colonoscopy. I would be extremely wary of taking a non steroidal anti inflammatory drug and never have had to thankfully.. I know that Prednisolone gives me moderate lower abdominal pain unless I take it with food and Lansoprazole. I find Buscopan helpful and have it prescribed now.

[Lassie2]

Thanks so much for the information

[PMRpro Ambassador]

Lower abdominal pain isn't usually associated with PMR? Was it something you had before you were given pred? Did you start taking pred and the diclofenac at the same time? I suppose it is possible the pred caused abdominal pain that was masked by the diclofenac.

Groin pain can be typical of PMR if it is causing trochanteric bursitis - it certain did for me, I thought I needed a hip replacement! Pred usually takes longer to make that subside - but the diclofenac might have had an effect too.

[Lassie2 in reply to PMRpro]

I had occasional groin pain before I was diagnosed with PMR although it moved about between both hips. It was only now and again but it was the most debilitating as without use of the core it is really difficult to move . Most of the time before diagnosis it was neck , shoulder and lower back pain and occasional arm pain.I was given the diclofenic at the same time that I got the Pred . The swelling has now gone down in my knee so have stopped taking them. Haven’t heard of trochanteric bursitis before . Many thanks

[PMRpro Ambassador in reply to Lassie2]

It is talked about a LOT on here! Greater trochanteric pain syndrome involves the outer thigh, groin and often the lower back if piriformis syndrome is also involved and is pretty common alongside PMR.

ncbi.nlm.nih.gov/books/NBK5....

nhsinform.scot/illnesses-an...

If you google it you should find exercises that usually help for piriformis syndrome - and also the GTPS.

[random901 in reply to PMRpro]

That second link was really useful, thanks!

[piglette]

PMR is pain of the muscles. You do not normally have abdominal pain with PMR . As the others have said get a Dexascan to check your bone density before taking a bisphosphonate such as Alendronic Acid, you may not need it. Don’t take an NSAID such as Diclofenac unless very short term. Don’t reduce unless you feel OK to do so. You should have been prescribed vitamin D with calcium.

[Lassie2]

thanks for the advice . I am afraid I need to go back to school to learn more about anatomy as I have just learnt that my abdomen is much further up from where I have experienced pain . I suppose my pains are in the pelvis area . Will not reduce if pain continues .