Bursitis and PMR?

[fondofforest]

I am just over 2 years into my PMR story and am down to 4mg. Prednisone as well as 300mg. Plaquenil. Lots of up’s and downs but trying to stay positive because I have been able to cope fairly well until this last month.

I started feeling a small aching pain at the back of my left knee about a month ago which got a little more sore everyday until now I have extreme pain in the knee and constant ache all down my calf with noticable fluid buildup just below the knee.

I have had an x-ray and ultrasound in the past week and the results were some osteoporosis in the knee and bursitis with a confirmed fluid sac.

The doctor has recommended I see an orthopedic specialist and so I am now on a waiting list.

In the meantime the pain is now borderline unbearable and I have no idea how to treat it without taking a lot of painkillers that I have been told to avoid because of the Prednisone and Plaquenil. I have also been told this latest development is not related to PMR even though it is clearly an inflammation development that I have read people with autoimmune disorders can be prone to?

Not sure what to do next and after a very short walk today in an effort to get some exercise I am completely unable to walk this evening!

Any help or suggestions would be so appreciated as always my friends.

[DorsetLady PMRGCAuk volunteer]

This link gives some info on knee bursitis and suggests what you can do -

mayoclinic.org/diseases-con...

Do you mean osteoporosis or osteoarthritis? Cannot find much about osteoporosis in knee except this -

onlinelibrary.wiley.com/doi....

[fondofforest in reply to DorsetLady]

I meant osteoarthritis. Thanks for catching that.

I found the Mayo Clinic online last night as well and it gives some good advice on the bursitis.

Thank you again so much for your reply!

[piglette]

I had dreadful pain in my hip for which I took Tramadol. I did not take NSAIDs though as they are contradictory with Pred. Have you tried Tylenol? You can check if you can take drugs together at webmd.com/interaction-check...

[fondofforest in reply to piglette]

Thanks so much Piglette I will check the drug interactions and see if there is something I can take without causing additional problems!

[PMRpro Ambassador]

Sounds to me as if you have reached a stage where waiting list is not where you should be - was the referral routine or urgent? I would get back to your GP and emphasise you are now next to immobile. Don't gloss over the situation and put a brave face on - gets you nowhere!

[fondofforest in reply to PMRpro]

Thanks so much. That is where I am as well I will give it until after the weekend and if there is no improvement I will definitely call my GP and ask to see a specialist sooner!

[PMRpro Ambassador in reply to fondofforest]

Don't just "ask" - be much firmer than that.

[fondofforest in reply to PMRpro]

Absolutely, if only we all had you to advocate for us. You are right though I have to be much less submissive in my dealings with all these medical professionals.

[Fireleigh]

The steroid you have been prescribed is probably not enough to dampen your pain. Limiting your activity should help. And increasing your dose. It’s very difficult . Good luck.

[fondofforest in reply to Fireleigh]

Thanks so much Fireleigh

[Potemkin]

my mum had bursitis but only that. She was told movement would help and it was suggested she walk in a swimming pool. I think the resistance and the support of the water helps.

[fondofforest in reply to Potemkin]

Thanks so much Potemkin!

[Pixix]

I have troachanteric (hip area) bursitis. I am on time release Tranadol & Buphrenorphine patches (high dose). The pain from my bursitis still breaks through those & it’s painful to walk. I find the only thing that helps is steroid injections…but they wear off after a couple of months. I find it’s worse in colder weather, the change in England this week is noticeably cooler, & I’m suffering. If you can afford it, I’d pay for first appointment, then transfer to NHS. But otherwise, as PMRPro says, tell your Dr you can’t walk, & get seen quickly! Good luck.

[fondofforest in reply to Pixix]

Thanks so much Pixix!

[Hidden]

I developed bursitis in my right hip and my rheumatologist gave me a steroid injection which helped but the pain was unbelievable.

[fondofforest in reply to Hidden]

Thanks so much PMRprincess!

[AshPen9]

I developed bursitis in my right foot in 2021, fondofforest, it was unbelievably painful, but only started to hurt if I walked a few miles. Eventually I had a steroid injection, but by that time I'd started to have severe hip pain, so I couldn't walk far enough to decide whether it had worked! The hip pain was initially diagnosed as PMR, which they then changed to Spondyloarthropathy, for which I take prenisolone. Presumably the pred has taken care of the bursitis for the last three years. Until now! Last week I had been doing a large amount of walking on and off for a couple of days. Cue return of Bursitis pain. I have been wondering whether another steroid injection was likely to be effective on top of the pred. I take 5mg plus 200mg Hydroxychloroquine (Plaquenil). There's not a big urgency for me, due to the pain only starting when I walk a long way, so I may wait until I see the rheumy in a few months. Good luck with finding something to relieve the pain. It's excruciating isn't it?!

[fondofforest in reply to AshPen9]

I am on almost identical meds! Currently 4mg prednisone and 200mg Hydroxychloroquine.

My rheumatologist would really like me to get up to 300mg of the Hydroxychloroquine and I am reluctant of course. The treatments for some of these ailments are so intimidating they add to the stress of the illness themselves Thanks so much for your response I really do appreciate it’

[AshPen9 in reply to fondofforest]

I tried 4mg last year but it didn't work out. Going to try a very slow taper to 4.5mg in a couple of months. In June I dropped from 300mg to 200mg Hydroxychloroquine. My rheumy says that its a dmard which calms the system and is particularly beneficial for people with a cardiovascular history. However, it can cause sudden and severe eye problems, and PMRpro has had things to say about that in the past. I don't think it's a drug that they want you to take forever, hence mine being reduced. The maximum dose that you are allowed depends on your weight. Good luck with your knee.

[PMRpro Ambassador in reply to AshPen9]

It is fine if you get your eyes checked frequently but a lot of doctors are a bit laid back about it when after a few years nothing has happened - but it can be a very late and very sudden consequence.

[fondofforest in reply to PMRpro]

Thanks for this reminder. My rheumatologist definitely knows and has told me about the possible eye problem and therefore my unwillingness to raise the dose. Everything is like a juggling act isn’t it!

[PMRpro Ambassador in reply to fondofforest]

It is - but not only for PMR. I had atrial fibrillation, sorted with an ablation but when I had a bisphosphonate infusion it triggered atrial tachycardia! So now I have to fiddle about with the medication to find what works best!! Discussed with the ephysiologist today and she told me to see how I get on. But I like doctors like that

[AshPen9 in reply to fondofforest]

I get a thorough check every year, and pay a bit extra for a more detailed OCT scan. Also have a 6 monthly check for contact lenses. I see the main man for that and he knows about the Hydroxychloroquine, so always has a good look around. After 5 years I have to go to the hospital for the annual check. I do worry about taking them from time to time, but another medical matter generally takes over (was in A&E until nearly 1am this morning with OH)! As you say, a juggling act.