hip stiffness

[Nanatoo]

I was finally diagnosed with PMR in July last year although I’d had all the symptoms for over 6 months. I was prescribed 20 mg prednisolone as a starting point and have tapered to 12mg. Probably should have stayed on 13mg until after our holiday as after 5/6 days I am getting aches and stiffness in my hip area as have been doing a lot of walking. Paracetamol has reduced the aches but not the stiffness so I’m not sure if it’s steroid withdrawal or a mild flair or just over exertion. Finding it difficult to get in and out of the car and walk up stairs. Walking is my preferred form of exercise but I probably only walk 4 times a week not everyday as I’m doing now. Advice please as I don’t want to increase the steroids if it’s considered unnecessary but I don’t want to be adding to the “dripping tap”

[SnazzyD]

I’d vote for over exertion due to the timing, especially if you were comfortable before the holiday. Pred/PMR muscles don’t like being over used and it is easy to get micro damage and the stiffness if they are not given a chance to repair. It often comes a couple of days later just as one is feeling smug at having got away with it. Sounds like you may have had too good a time due to the feel good factor of being on holiday. Pred tends not to help but paracetamol usually helps depending on how upset the muscles are. Load bearing muscles tend to whinge more because you have to keep using them to get around so paracetamol may not work 100%.

[PMRpro Ambassador]

I think it is probably too much walking all at once as well. Me being me, I never had a fear of going up if I needed it and I would try it for a few days to see if it helps - you can go back down if it doesn't. And definitely watch out for it getting worse rather than better.

And yes - never taper if there are any changes to routine on the horizon, especially if you are settled where you are. That way it is easier to tell what woke it up.

[DorsetLady PMRGCAuk volunteer]

Steroid withdrawal comes on almost immediately and should recede after 4-5 days as body accustoms itself to new lower dose. Flare symptoms are likely to appear anything after 7 days or so…

.. but would agree probably too much walking, maybe have day resting and see what happens, and increase a little as suggested by PMRpro if required.

[Nanatoo in reply to DorsetLady]

Very hard to rest when on holiday with friends or family as prednisolone makes us look pretty normal so they forget we are anything but!! and we love to be spending time with them. Will rest when we’re home in a couple of days and see if I have any “discomfort” and take it from there. Thank you to you and PMRpro for your advice

[DorsetLady PMRGCAuk volunteer in reply to Nanatoo]

I went on holiday with my son and extended family to Spain a couple of times and visited my daughter and family in NZ for 6 weeks when I still had GCA.

I explained to both children that I may not be able to indulge in all the activities they did, not because I didn’t want to, but I couldn’t physically … and if I felt like sitting some out, I’d tell them … they both fully accepted that.

You have to be honest to yourself and others…. Once you’ve explained that, it’s not an issue for anyone… or shouldn’t be. 😊

[WhatNoCarbs]

I think I may be having similar issues. I’m on 10mg and before 2 wk holiday had mild ache in left shoulder and groin in morning which I was OK with. Went on the holiday. Every 2nd day did 10-12miles (to help with Osteoporosis). Came back congratulating myself and started planning out the next walk. However, I thought I came down with a bug - fainted Easter Sunday with slight digestive upset. I still have very low energy. Aiming to have blood test done on Monday. But wonder if it’s a PMR slight flare, i.e. low iron, aches slightly more consistent, but OK after lunch (as pred has kicked in by then). Perhaps I should just go up to 15mg for a week? On Doctors advice I’m not taking my Alendronic today in case it’s that (been on it a year now). Any thoughts?

[DorsetLady PMRGCAuk volunteer in reply to WhatNoCarbs]

Might be worth upping Pred for a week…. But was your walking on holiday more than you had been doing at home - if so, it could be a combination of DOMS [delayed onset muscle soreness] and just too much activity. However, see how it goes.

As for digestive issues, more likely a holiday bug… if you’ve been on AA for a year, it seems odd it’s only just affecting you now.

[WhatNoCarbs in reply to DorsetLady]

It was more walking than normal. Before we had just done that distance at weekends. I have a sit down at home job and rarely move during the week. Try to go out for short walk each day, but cannot always fit it into the schedule. Will readdress that once I’m better. (Never heard of DOMS - will look into it.) AA side effects were gradually getting worse - so I am rather glad of the temporary break!

[DorsetLady PMRGCAuk volunteer in reply to WhatNoCarbs]

DOMS-

healthline.com/health/doms

AA-what symptoms? Break won’t do any harm - there are other options -have you looked at ROS site

theros.org.uk

[PMRpro Ambassador in reply to WhatNoCarbs]

I have to suspect exhaustion!!! With a touch of adrenal related exhaustion to go with it! Even doing extra and enjoyable physical activities usually results in a boost of cortisol to get your body through it and it wasn't available.

Any symptoms you are confident are related to taking anything that are getting worse are a sign to stop taking it!!! What is the AA causing?

[WhatNoCarbs in reply to PMRpro]

Thanks for all your kind responses. I consider myself fortunate that I was able to achieve the distances! The AA effects were more digestive in nature. Anal mucus a few days after taking it - not pleasant and a bit embarrassing! It started when I started taking AA, wore off towards the weekend. Now some time on, I think body has had enough.🥴

[PMRpro Ambassador in reply to WhatNoCarbs]

If you are getting worsening gastric problems you should stop it and have it investigated - just in case.

[WhatNoCarbs]

My thoughts too. If it doesn’t happen this week after not taking AA then I’ll be less inclined to worry!

[PMRpro Ambassador in reply to WhatNoCarbs]

Might take more than a week to calm down if there is erosive damage ...

[WhatNoCarbs]

I’m hoping it’s just a chemical issue. But even that may take time of course. Will let you know how I get on over the next 2 wks.