Hands & Shoulders Pain When Tapering from 8mg

[Lickle]

Hi All,

I was tapering down great and doing a lot of cardio in the gym three times per week. As I got fitter, I started doing some lightweight repetitions. I had lost weight on a low/no-carb diet. I got down to 8Mg on Prednisolone, but after the exercises, I started to get stiffness in my hands and shoulders. It was hard to tell if it was natural gym stiffness or the PMR returning.

I was doing three sets of 50 Push-ups, plus three sets of one-minute 30-second Planks and Wall Sits, along with various cardio of between 4 and 5 km on the treadmills/bikes/rowing machines.

I'm a writer, so I am always at the keyboard, and I wondered if that hand stiffness was a form of arthritis. But I was due to taper down to 7Mg this week and did so on Thursday.

I thought that the hand/wrist and shoulder stiffness was due to those particular exercises, but after a week of not going to the gym, I feel that it is probably the PMR, and I was pushing things a little too much.

It's Saturday now, though, and my shoulders and hands are worse, with a slight feeling of tightness around the back of my head and neck. I am now convinced that it is the PMR and need to raise the dosage. Maybe go back up to 9mg or 10mg. What would you experienced PMR Pros recommend?

I will call the GP and also get his suggestion.

[PMRpro Ambassador]

Treat it as a flare and use the flare protocol - add 5mg to the dose where it occurred for about a week and drop back to the last dose where you were good. You can stay on the higher dose for up to 10-14 days if you need to because you left it too long before starting.

Those reps figures are eyewatering - did you dive straight in to that level or did you build up to them very slowly as we recommend? The feeling this morning is most likely a response to that drop on Thursday, the 8mg was the borderline, 7mg is too low and your body is telling you.

I'm also at the keyboard all day - given the amount I write on here!!! - I find it keeps most of my hands and wrists mobile. But if it is arthritis it is likely to progress over time - and some of those exercises you mention require leaning on your hands - and that is what I find very uncomfortable, have done for years since PMR started and affected my hands and feet quite badly. At times lifting a wine glass was excruciating. Once I was on pred (after 5 years undiagnosed) the hand and foot pain faded. The foot pain has never returned in the same way. The wrist pain from then returning has always been the sign of an incipient flare.

[herdysheep in reply to PMRpro]

Nothing worse than big pain lifting a wine glass. Sorry to be a bit flippant - must be exhaustion brought on by reading about that level of exercise

[PMRpro Ambassador in reply to herdysheep]

I thought so too at the time!!!! Especially since the best part of the day in terms of PMR symptoms was after a glass with dinner in the evening!!

[herdysheep in reply to PMRpro]

😂😂😂

[Lickle in reply to PMRpro]

Thanks so much. I didn't know the flare protocol, so I will do that. The sheet my GP gave me didn't mention that. Yes, those exercises did require a lot of pressure on my hands and shoulders. I built up to those reps fairly slowly. I'll drop the sets down to 1 per day instead of 3 sets x 3 times per week and see how that goes.

[DorsetLady PMRGCAuk volunteer in reply to Lickle]

The sheet my GP gave me didn't mention that.

That’s because many don’t know about it…. they just say return to previous dose… sometimes that may work, very often it doesn’t…

[Paulagcl in reply to PMRpro]

That's the last straw, pain lifting a wine glass!!!

[Mfaepink1973 in reply to Paulagcl]

My thoughts exactly! 🍷

[Italybound62 in reply to PMRpro]

PMRPro. Would you mind please posting the link(s) to your protocols including the flare protocol you mentioned here. I know I’ve seen them somewhere. I’m searching and searching and can’t find them Thank you.

[PMRpro Ambassador in reply to Italybound62]

You will find them all in the FAQs, under T for Tapering

The FAQs are linked at the top of every thread in a box immediately under the title post and also listed in the Pinned Posts. It's really a good idea for you to get in the habit of looking at them so you are familiar with them and know what is there so you can find them easily yourself.

DL has also already linked them in the reply immediately below this one.

healthunlocked.com/pmrgcauk...

[Italybound62 in reply to PMRpro]

Thank you so much. I found them right as I hit send. sorry about that. 🤦‍♀️

[DorsetLady PMRGCAuk volunteer]

As PMRpro has said you need to treat as flare-the odd 1 or 2 mg is unlikely to be enough..

healthunlocked.com/pmrgcauk...

.. and ease up on the reps!

[AtopicGuy]

You are being prescribed corticosteroids because your doctor believes your immune system is attacking healthy tissues related to your muscles. The aim of corticosteroids is to suppress your immune system, to provide a window of opportunity for your tissues to recover, and for your immune system to correct itself. This is less likely to happen if your body continues to be exposed to stress, and your immune system is highly active, repairing exhausted muscles. Corticosteroids are not like anabolic steroids: they do not promote muscle growth.