If paracetamol helps, can it still be PMR pain?

[AgMuirhead]

Good morning. I began this journey in October 2022 on 15mg Pred. I managed, without much difficulty, to taper to 6.5 mg a few weeks ago (I previously reduced to 7mg 11 months ago but increased the dose after aches and pains started creeping in, and started a slower taper). Recently, after a couple of weeks on 6.5, I started to feel a bit unwell (stiff neck and shoulders, achy, generally feeling under the weather). Taking 2 paracetamol seems to alleviate the symptoms a bit, so can this still be PMR pain if I get a bit of relief from Paracetamol?

It’s hard to know what might be a flare from steroid withdrawal/stuttering adrenals or maybe having a bug of some sort.

Thank you, in advance, for any advice. This forum is a godsend. I don’t know what I’d have done without it.

[DorsetLady PMRGCAuk volunteer]

We do often say ‘if paracetamol helps then it’s not PMR’ - but many find it does help with the steroid withdrawal issues.

I found my SW symptoms always seemed to be the generally feeling unwell type - certainly at the higher doses and lasted about 3 or 4 days. When I started a slower tapering as I got lower that seemed to stop the problem.

Would also say a couple of weeks into new dose is about normal time for body to realise not quite enough Pred - so although paracetamol may have given ‘a little relief’ - I’d still be thinking -is it a flare?

As you also say at this level, adrenals are stuttering….so that adds in another element to consider.

Sorry to say, it seems a bit of a ‘suck it and see’ problem …not sure we can give a simple solution.

Think I might stick with the paracetamol for a few days as it’s all a bit vague….and monitor things. Obviously if things get worse then you need to rethink options..

[AgMuirhead in reply to DorsetLady]

Thanks, DL, for your reply. Much appreciated. As the days pass, the neck and shoulder pain seems to be firmly setting in in the mornings so think I’ll maybe have to up my Pred dose (with reluctance).

[DorsetLady PMRGCAuk volunteer in reply to AgMuirhead]

Think you have answered yourself then 😊…

[PMRpro Ambassador]

"a bit of relief" suggests the difference isn't that marked? And to be honest - 1/2mg more pred is almost certainly safer in the long run than daily paracetamol, depending on how much you are taking. Paracetamol is not an entirely innocuous smarties-type pill - it too causes damage if used longterm at a significant dose. And it does sound as if it is getting worse - steroid withdrawal or adrenal aches should be getting better.

[AgMuirhead in reply to PMRpro]

Thank you! Yes, you’ve pointed out what I’ve been suspecting……it’s going on a bit too long!