PMR or arthritis?

[Jackie_boy]

I was diagnosed with PMR a few years ago and have gone through the process of taking 15mg prednisolone and then reducing- now stuck at 6mg and have tried a few times to drop a bit without success. About three or four months ago I began to have a very tight lower back and this became sciatic pain for a while which I have dealt with using an exercise programme so that the physio tells me that my pain is not from the sciatic nerve any more. However I still have some tightness when I walk and radiating pain from the hips down my legs. I also have some shoulder pain on one side and in my hands. My GP is sending me for X-rays of the hips and hands and doing bloods to check inflammatory markers.

The question is whether PMR and arthritis are closely connected or even basically the same ? I’d be interested in others’ experiences - so far there’s been no mention of increasing the steroid dose but is this perhaps the answer in the end? I can reduce the pain for a while with paracetamol and keep this to a low dose daily I’ve always had good responses by posting here and would appreciate any comments, thank you.

[PMRpro Ambassador]

What you are describing is almost identical to symptoms I have which are due to PMR and its associated condition myofascial pain syndrome. The sciatic nerve may no longer be pinched, but I'd lay odds other muscles are still tight and causing problems. I do have signs of arthrosis (osteoarthritis) in my lower back though and that doesn't help. Arthrosis occurs due to wear and tear of the cartilage at the joints. It usually happens because of aging or intense use of the joints during sports, exercise or other activities - or just standing upright for 70+ years ...

You are lucky paracetamol helps - doesn't touch mine! My lovely rheumy eventually did an ultrasound-guided steroid injection in the sacroiliac joint and the relief was immense. I had been in the middle between the Pain Clinic doctor who had a fit at everything I found worked and the cardiologists who wouldn't let me stop the anticoagulant to have injections. My rheumy is highly skilled and was willing to do it - no problems with it at all.

[Jackie_boy in reply to PMRpro]

Thank you for your reply, not totally comforting but at least it goes a long way to explain what seems to be going on. I have never been referred to a ‘rheumy’ - NHS referrals around here are very thinly spread and I’m not even sure there is someone available at an easy distance- but I will now get on to my GP and ask. Thanks again!

[DorsetLady PMRGCAuk volunteer in reply to Jackie_boy]

Not everyone with PMR sees a Rheumy,,,,although it recommended that you see one once -to check it is PMR. But as you say it’s not always easy -and a good GP is quite capable of treating PMR -so long as your don’t have complex health issues.

Many have osteoarthritis as well as PMR OA affects joints -and PMR affects blood vessels -including those surrounding joints. Both are autoimmune diseases but not directly linked.

Or do you mean inflammatory arthritis?

[arvine in reply to PMRpro]

Really considering guided steroid injection after discussion with orthopaedic surgeon, he wants anothet MRI first , before going ahead with anymore spinal decomprssion therapy, how long can I ask does this injection give you pain relief, although seems different for everyone

[PMRpro Ambassador in reply to arvine]

I have no idea - it's working so far, 3 months so far maybe. Sometimes it doesn't work at all. Sometimes it deals with the inflammation and it doesn't return - depends on the underlying cause. I still have back pain in the mornings, just not usually as bad and almost certainly muscular rather than an inflamed joint. The pain may well be due to arthritis and there is little or no remedy for that. Stress also doesn't help. But we've said this all before - our answers aren't going to change.

[arvine in reply to PMRpro]

Thank you.yes heard some andwers before but think lots of new treatments , researches etc never know if something new out there , re experiences or meds etc

[arvine in reply to PMRpro]

Also along with lower back seizing up and pain when standing or walking for over 10 min, want to add , every morming on waking , trying to get out of bef, my whole body feels like lead! And stays tjat way for at least an hour after up and moving, my dr says I have had a lot of stress over last number of months, so loe energy and lethargy to be expected, but it gets me down mentally and depressing, wondering is this part of arthritis condition that some people experience, Am trying to taper to 4 mgs again, ad ortho dr shared same opinion as I have, rhat pred weakens muscles and tendons and MRI in Jan 2024 , showed several tears he said

[Jackie_boy]

Thanks for replying; I don’t know what to expect with the potential arthritis investigation, although there is osteoarthritis in my family history and that’s what the GP homed in on. My finger joints are very knobbly and painful!

[DorsetLady PMRGCAuk volunteer in reply to Jackie_boy]

Have a look at this -

versusarthritis.org/about-a....

Heberdens nodes

[PMRpro Ambassador in reply to DorsetLady]

There are more Bouchard's nodes there - Heberdens are the one affecting the joint nearer the fingertip. Bouchards make the proximal joint swell and are usually less common. Says in the article they usually burn out with time and stop hurting - my single one in my right index finger has started hurting again!!!

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

That’s what search brought up -this better?

My right index finger (B) -pain and goes -and fortunately not too bad

Nodes 2

[PMRpro Ambassador in reply to DorsetLady]

Using a steak knife can be awful!!!

[Thelmarina in reply to DorsetLady]

Very helpful - thanks 👍

[Pixix]

I don’t think they are basically the same…(OA & PMR), but I have both, & my Dr thinks I have inflammatory arthritis, too. I also have trochanteric Bursitis, lots about that on this forum, you can use the search field to find more info. I had my Bursitis injected with steroids 3 weeks ago, it’s the only thing that helps me…but I have sciatica on the other side!! I think, if I look into it properly & involve my GP that I may have myofascial syndrome, which is associated,M as PMR Pro talks about above. I find my GP of better use regarding OA. I did see a rheumy for OA in my feet as she could refer me to Podiatry, but the next rheumy I saw (about hypermobility) just handed me a booklet on OA to read, & that was that!! Oh, & a booklet on hypermobility, but no help. You may be luckier, of course! Versus Arthritis is a great source of info…& yes, I have the nodules on fingers!

[AtopicGuy]

Arthritis means "disease of the joints". Polymyalgia means "pain in many muscles". They are definitely not "the same". They can be confused, however, because the major joints (eg. shoulders, knees and hips) are surrounded with muscles that help to keep the joint stable. Pain in these encapsulating muscles can easily be described as 'joint pain' when, technically, it is not.

Historically, the disease we now call PMR was first identified precisely because it presented differently to arthritis, which often reveals itself as hot, painful, swollen joints which hurt when pressed or moved.

That said, there is considerable overlap between PMR and arthritis. That is to be expected, however, because both are much more common in the elderly. Inevitably, some patients will show signs of both.

I am 61 and have terrible muscle pain and stiffness, especially in the shoulders. However, I do not have a diseased joint in my body (yet).