PMR flare or not…: morning all I really don’t know... - PMRGCAuk

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PMR flare or not…

Doraflora profile image
19 Replies

morning all

I really don’t know what to do atm.

I did a slow taper down to 2.5mg Pred and at the same time I thought I’d pulled my knee doing an exercise class as my knee swelled up & felt very sore (about 6 weeks ago this started)

The GP thought it was arthritis but the physio she referred me too thought it was the exercise class. However, when I saw the physio again a few days ago he said arthritis/inflammation.

I stopped the exercises he gave me as they made the knee worse, but a heat pack is really helping.

I told him that when I’m in bed I get pains down my calf, but he didn’t seem to take any notice! I keep banging on to him about getting a scan, but he said to see how I get on with a knee support first.

I’m tempted to up my Pred, but really don’t want to do that unless absolutely necessary.

I guess what I’m wondering is, if anyone else has ever suffered with a swollen knee/pain in the kneecap while on Pred. (I’m just over 4 years into PMR and have never seen a rheumy).

In fact sometimes I do wonder if I was wrongly diagnosed with PMR (diagnosed over the phone during Covid). Recent blood tests showed my CRP at 0.8.

Sorry for the long ramble!

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Doraflora profile image
Doraflora
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19 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

If a heat pack helps -they maybe try painkillers initially and see it they help.. not sure it’s PMR either.

PMRpro profile image
PMRproAmbassador

I did at the early stages but it improved once I was on pred. However, I think it sounds more injury-related than anything else to be honest.

Doraflora profile image
Doraflora in reply to PMRpro

Thanks, PMRpro, that’s why I was very reticent about upping the Pred dose.

Or it could be something to do with “old age” - a title I never use🤣

PMRpro profile image
PMRproAmbassador in reply to Doraflora

advancing age? That applies as 20 as much as 60 or whatever ...

Doraflora profile image
Doraflora in reply to PMRpro

Ha. At 72 I still don’t think I’m “old”, its only the joints that gives me a jolt.

I still have fun when I can like I did in my 60’s - or even younger!

Louisa1840 profile image
Louisa1840

I went ziplining in the Daintree Forest 2 years ago age - 72! I was terrified but wanted to prove to myself I could do it. It was also for my older brother who had died a week or so previously. I did it for him as he would have roared with laughter at my terror!

diana1998 profile image
diana1998 in reply to Louisa1840

👏🥴

Doraflora profile image
Doraflora in reply to Louisa1840

Wow, well done👏

Broseley profile image
Broseley

Hi, I don't know if you saw my recent post, but I have had knee pain since early May, with shooting pains down my calf and across my foot. It was slowly getting better; I could walk further with a stick and climb the stairs but coming down again was trickier.

I was using Flexiseq as recommended on here.

Then my hip on the other leg developed sharp inguinal pain and it felt like my leg would give way. I had to cancel our holiday. Long story short: rheumy discharged me saying knee is arthritis. XRay showed only mild arthritis. GP thinks it's related to my back - L5 to be precise, so I've had XRays on that and my hip. No results yet.

Meanwhile I upped my pred dose by 5mg - the flare protocol, just in case. Within 24 hours all hip and knee pain had gone. I took 5mg for 4 days then went back to half mg. No further pain a week later.

In essence, I would recommend you do this. It's worth a try and can't do any harm if just for a few days.

Doraflora profile image
Doraflora in reply to Broseley

Hi Broseley. I’ve thought about upping the Pred a lot, but was really hanging on as long as poss to see how my knee goes.

It’s not bad enough to take pain killers and ok until I’ve done some walking, then it swells up again. A heat pack does help.

But it’s the weird “tingles/sharp pings” down my calf when I’m in bed that is odd.

I still think the key cause was an over-exertive exercise class - coincidental with dropping to 2.5 mg Pred.

But I’m definitely going to push for a scan. It’s the least the surgeon can do seeing as I’ve never, ever been referred to a rheumatologist for the PMR.

Broseley profile image
Broseley in reply to Doraflora

Mine is the same, especially when I'm lying on my left side (it's the right knee). I'm hoping the referral I got to Musculoskeletal will result in a scan. I also get tingling and kind of numb feeling in my foot, like if you've been kneeling and your foot goes to sleep. This is still happening, but only in bed and there's no pain. It won't harm to try an extra 5mg for a few days.

Doraflora profile image
Doraflora in reply to Broseley

Thanks, Broseley. 👍

Doraflora profile image
Doraflora in reply to Broseley

Hi Broseley. I upped my Pred today from 2.5 to 5mg as you suggested and this evening I can’t believe the difference it’s made! Getting in & out the car - no trouble at all, and walking normally! And: no pains at all!

My knee is still swollen so that indicates to me it’s probably unrelated to PMR. But because I’m feeling so much better pains wise, I’m hearing PMRpro probably saying I was on too low a dose before at 2.5mgto manage PMR.

But I’m so keen to get off this med and all the associated ones (Omeprazole and AA). Yes, I’m being totally naive aren’t I. It is what it is.

Broseley profile image
Broseley in reply to Doraflora

Oh I'm so glad! I call pred the "magic bullet". I was able to go back to half a mg after 4 days. That was 2 weeks ago now, and I'm still OK.

I was asked to have a blood test at the surgery for my meds review so I asked them to test my ESR and CRP. All normal. And I'm pleased that my HbA1c is still ok though my cholesterol is still 5.3 despite doubling my dose of statin.

My hip XRay came back as fine, so it must've been inflammation. My spine XRay came back as severe arthritis so maybe the GP was right about this causing the shooting pains down my calf and across my foot. But my back is fine - no pain at all and never was. I have to see her for a follow up. Meanwhile the shooting pains are nearly gone, I just get a bit when I lie on my side in bed.

Pred is a very useful drug, and I'm reluctant to give it up. I'm going to try to stay on half mg indefinitely, so it doesn't drop off my repeat prescription.

I'm so pleased for you, and you could try dropping your dose again now the symptoms have gone. Maybe see if you can get a blood test and XRays too?

Doraflora profile image
Doraflora in reply to Broseley

Thanks Broseley. I think I’ll stay on the 5mg for another couple of days & then revert back to 2.5mg.

but the main thing is: this morning my knee isn’t as swollen 😄. I’ll see how it goes throughout the day walking on it, but maybe the higher dose of Pred is kicking the inflammation on the knee as well.

I’m glad your results are normal, that’s good.

Onwards and upwards!

KCRoyals profile image
KCRoyals

Keep at him till you get the scan and a further CRP/ESR test. That's the only way they can pin down what is affecting your knee. I used a physio without success, helped for a couple of days. Can be so many things. I started like that, now the last resort is a knee replacement. Really important to get the scan to check how far the knee has degenerated.

Doraflora profile image
Doraflora in reply to KCRoyals

I agree, KCRoyals.it seems like the physio is just going through the motions of tick boxing until the last resort is a scan. I’ll be on it when I see him next.

In the meantime I’ve just bought a knee support to see if that helps….

Judigardener profile image
Judigardener

I have had pains in my calf muscles. Mine is B12 deficiency. So much better since I’ve addressed this. I’m heading into year 11 of PMR !

Doraflora profile image
Doraflora in reply to Judigardener

Year 11! Oh my😲

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