Could this be my PMR changing to GCA?

[Sungolfer]

Hi,

I have reduced from 15 mg from last October and now down to 5. i have been extremely well mostly and nearly looking at reducing by 10%. For the last week or so I have been conscious of a slight headache and neck ache - nothing dramatic and taken paracetemol which has helped. Slight discomfort in jaw - not when eating - thought it was a tooth ache?!

I am wondering if this is just a coincidence or whether it might be the start of GCA - my Dr is on holiday. Could i up my dose of Pred dramatically for a very short time and see if it makes a difference or should i get to the Dr for tests etc. Advice please would be much appreciated.

Thank you.

[DorsetLady PMRGCAuk volunteer]

If paracetamol helps, and jaw doesn’t hurt when chewing, then unlikely to be GCA - but I’d never say never.

Maybe have a look at TMD/TMJ issue initially..

You could also try an extra 5mg for a few days if links don’t seem relevant-

nhs.uk/conditions/temporoma...

webmd.com/oral-health/tempo...

[Sungolfer in reply to DorsetLady]

Thank you - will try extra 5mg for few days - then if improved I can drop back to 5 yes?

[DorsetLady PMRGCAuk volunteer in reply to Sungolfer]

Yes…

[SnazzyD]

.As DL says, doesn’t sound obviously GCA-like but…

Do have a read if this about neck muscles too. You do need to keep on top of this easily set up stiffness that can mimic GCA if you’re looking for it.

healthline.com/health/stern...

[PMRpro Ambassador]

I wouldn't say you are describing anything to make most of us worry, especially if paracetamol helps. Keep an eye on it, don't reduce any further and see what happens.

Have you done anything to upset neck muscles recently? They could cause all those effects,

[Sungolfer in reply to PMRpro]

Hello and thank you - will keep eye on it and as just said to Snazzy D - maybe too much golf!!! very appreciativec of speedy replies.

[PMRpro Ambassador in reply to Sungolfer]

Ah yes - I did wonder!!!

[Grammy80]

Sometimes, it seems the one constant...is the difference! Can you get in for a blood test to check inflammation markers? I believe they are normal about 20% of the time, even though inflammation is present, so your symptoms are your best guide. I'd be vigilant and see if you can sort out the neck muscle pain. Is it too much golf? If it goes from the neck to the back of your head, I would see if 'you can make it go away.' I've not heard too many talk about it, but it was one of my earliest symptoms of GCA. Hope you feel better~💞

[Sungolfer in reply to Grammy80]

Thank you for your reply. I’m going to be watchful and if still there next week will contact surgery. Before I was diagnosed with PMR last September/October I had been suffering with a really bad stiff neck for weeks which did go into the back of my skull. Soon as I started Pred it went. This one is different - not so painful no stiffness on turning - just sort of tired ache up centre! Will see how I go!

[AtopicGuy]

Some patients find they develop sensitivity in the teeth while on steroids (which can demineralise the teeth and bones). This can begin as toothache and later turn into sharp pains. You could try using Sensitive toothpaste; most brands produce one.

Are you taking calcium & vitamin D supplements?

[PMRpro Ambassador in reply to AtopicGuy]

And some people develop sensitive teeth with PMR, long before pred appears on the scene. Not always pred - as with so many things. In fact - PMR can cause several things that pred is usually blamed for!!

[Sungolfer in reply to AtopicGuy]

Thank you - yes I do use sensitise sensidyne repair. I do take D-cal but hit and miss im afraid 😟

[Sungolfer in reply to Sungolfer]

Sorry spelling mistakes b. Predictive and chubby thumbs!

[AtopicGuy in reply to Sungolfer]

I found brushing twice a day with 'sensitive' toothpaste wasn't always enough when on prednisolone. So I dissolved a pea-sized blob of the same toothpaste in a small bottle of water and rinsed with this between meals. It seemed to help.

[Sungolfer in reply to AtopicGuy]

Thank you thats a good tip - will try it.

[MaritimeMags]

I hardly ever get a headache - very lucky, some people would say. So when I do get one, GCA always comes into my mind.

I check my temples for any unusual inflammation.

Recently a headache has come and gone behind my eyes on four or five occasions - Paracetamol has made it go. I am putting these headaches down to the stress of recent stays away from home and deadlines with airlines and planes. Even the tiniest headache I worry might be GCA but my understanding is that symptoms are a bit more obvious like deterioration of eyesight and inflammation of blood vessels around the temple area. I hope I am right in saying this.

[PMRpro Ambassador in reply to MaritimeMags]

They are usually - bit there is also a form of GCA that has no symptoms.

[DorsetLady PMRGCAuk volunteer in reply to MaritimeMags]

Not 100% correct -you don’t always have issues either with temporary arteries nor sight issues.

The headaches are not like any you have ever experienced before - and certainly don’t go away with paracetamol.

But any new headache should be checked out… especially if it’s not something you normally suffer with.