Prednisone masking various pain issues?

[arvine]

I have read prednisone does not treat certain pain issues ie “arthritis” yet I am also seeing many commemts about prednisone “masking” certain issues, seems like a contradiction, and resulting in a view that prednisone is a pain killer/anti iflammatory, for other conditions other than pmr, ?

[piglette]

Pred tends to be used for inflammatory types of arthritis, such as rheumatoid and psoriatic arthritis, rather than osteo arthritis.

[arvine in reply to piglette]

May have asked this before, so many things going on with me cant remember, but how do they distinguish, inflammatory, or psoriatic arthritis from odteoarthritis?

[AtopicGuy in reply to arvine]

Osteoarthritis is wear & tear of the joints, eg. damage to the cartilage buffers that keep bones from rubbing together. It often presents with characteristic patterns of pain when the joint is used or manipulated. Unless mild, it can usually be seen in x-rays and/or scans. Steroids will not help osteoarthritis, unless the damaged tissues also become excessively inflamed; but when the inflammation is reduced, the underlying condition remains.

Like PMR/GCA, rheumatoid arthritis and psoriatic arthritis are autoimmune diseases. The inflammation (heat, swelling, stiffness, fever, pain, etc.) is caused by the body's immune system attacking its own tissues when there is no injury or infection present that would justify an immune response. Sometimes markers in the blood reveal the disorder. A strong, rapid response to NSAID or steroids tends to confirm the diagnosis.

[arvine in reply to AtopicGuy]

What are NSAID s?

[PMRpro Ambassador in reply to arvine]

Non-Steroidal Anti-Rheumatic Drugs - such as aspirin or ibuprofen amongst others,

[AtopicGuy in reply to arvine]

Here's a list:

medicalnewstoday.com/articl...

[darkred in reply to AtopicGuy]

I understand that a response to an NSAID usually confirms it's not an autoimmune condition such as PMR.

[PMRpro Ambassador in reply to darkred]

Not at all - some of the spondyloarthropathies can be managed with NSAIDs, Naproxen, ibuprofen and etoricoxib are all effective in the short term for axial spondyloarthropathy and are used first line. They are autoimmune disorders.

[darkred in reply to PMRpro]

Interesting! It seems there are exceptions to almost any "rule." Ankylosing spondylitis does respond to NSAIDS -- and it is believed to be an autoimmune disorder. NSAIDS are also used for rheumatoid arthritis, which is autoimmune.

Unfortunately, they do zilch for PMR. 😒

[PMRpro Ambassador in reply to darkred]

Exactly!!

[arvine in reply to PMRpro]

Hello, you seem to be an expert for advice on so many issues, so would appreciate yourvadvice re my recent pain issues, MRI done aug 3, both hips, a lot of medical jargon dont understand , but recd results just today through pocket health, report states, some tears, some cysts, subchondroal fracture right hip, simething about femoral head , severe osteoarthritis in right hip( pain in groin hip and front thigh now over 6 weeks) and appt today dr cancelled because he hadnt recd this report yet , next appt available in November, at my wits end with chronic pain every day, on 4 mgs prednisone been told cant take any other anti inflammatorys, tylenol doesnt help my pain, with your experience what is your advice?

[PMRpro Ambassador in reply to arvine]

Call that doctor NOW and ask for advice on management. Interestingly, I know someone else who has developed a similar hip stress fracture (that just means not due to a fall, it happens) in the hip. The first line treatment is a period of non-weightbearing, i.e. using crutches to mobilise and then reassessment.

This explains it very clearly

healthline.com/health/subch...

[arvine in reply to PMRpro]

thank you I have left 3 messages with his secretary and no respnse yet, have contacted my GP and they are trying to get copy of MRI today, they dont accept shared pocket health, hoping he can help with advice to next step, nd this ortho dr I speak of is the best in region , head of ortho dept all kinds of positive terrific reviews, so hoping to have him look into my case, dont know wh

[AtopicGuy in reply to darkred]

There are many strands to the immune system. Different drugs suppress different strands via varying routes. NSAIDs work for some autoimmune conditions (including rheumatoid arthritis). Steroids work for almost all autoimmune conditions, because they suppress many strands at once.

[darkred in reply to darkred]

Perhaps it is more correct to say that response to an NSAID usually confirms it is not PMR (an autoimmune condition).

[JessJess21]

hello - i saw my consultant rhematologist last week and he doesnt think i have PMR - or at least it’s atypical. So he says steroids are masking and im using them as painkiller so hes taking me off them in 6 weeks to see whats really going on. So it is possible. But i suppose everyone is a bit different. It was interesting to see different treatment re consultant vs GP.

[arvine in reply to JessJess21]

And what is your current dose of prednisone currently?

[Pixix]

steroids masked my arthritis, which is inflammatory. That’s steroids ‘masking’ inflammation. In my case it was a bad thing, as it means my arthritis was getting worse without me realising & I was over using my joints & mistreating them. As my steroids got lower the arthritis was then obvious & I was given supports to wear & help with what to do & not to do. It shows it’s bad to try to use steroids as painkillers…the pain is there for a reason & its important to f8nd the cause & treat it, I think.

[Carrollee]

I found that as I got lower on my the pred, old problems started letting me know they were still there. One of them was arthritis in my neck. I was barely aware of it on higher doses. Have got used to it again. Now have it in my knees and creaky feet 🦶 🤷🏼‍♀️🤗

[Broseley]

I got down to half mg pred. My right knee became painful, with additionally shooting pains down from my knee to my foot and across my foot. My shoulders became stiff and I couldn't do my bra up. Left shoulder worse than right. Rheumy said "arthritis" and discharged me, telling me to stop pred. Then I developed agonising sharp pain in my left hip. Combined with the knee I could hardly walk. I went to GP who sent me for XRAYS. No arthritis whatsoever in my hip, mild only in my knee, nothing in my shoulders. Meanwhile I took 5mg pred for 4 days. All the symptoms disappeared!

My GP says it was a PMR flare, even though it wasn't bilateral pain. That was a month ago and I'm still pain free.

So I'm confused about this issue too. I guess the acid test was the XRays. No arthritis so it must be PMR.

[CoziNess]

I've had erosive arthritis since my 30s with gradually increasing pain. This disappeared when I began taking Prednisolone. And now I'm down to a low dose it's coming back.....however it does this, it's great!