IM dose of Depo-Medrone

[Jones3]

It has been over 5years since I was diagnosed with PMR and I have been on 5mg of prednisolone for nearly 4 years (with a low of 3). However, I still have fairly significant symptoms - these have morphed slightly over the years but it is difficult to actually explain the difference. I have, however, noticed that walking has become more painful.

After discussion with my rheumatologist, I tried increasing my dose to 10mg for 5 days before dropping back down to 5mg. This made no noticeable difference to my symptoms.

At a further consultation, my rheumatologist gave me an IM dose 0f Depo-Medrone as a therapeutic test. This also made no difference to my symptoms and on the back of this she thought it reasonable to conclude that there is no active inflamation.

I am awaiting the results of an MRI scan to check for lumbar canal stenosis.

if there is no inflamation we have also agreed that I should try and taper down very slowly to see if in fact my symptoms worsen.

I would appreciate any advice from you knowledgeable people as to what might be going on here and/or what I should be doing

Many thanks

[PMRpro Ambassador]

Have they done anything simple like hip and lower spine x-rays? I have some inflammatory arthritis in my lower spine and pelvis that cause various discomforts and sometimes excruciating pain. Oral pred doesn't necessarily help. If I get a steroid injection it isn't deep i.m., That is effectively a lower daily dose over weeks and sometimes it needs the blast of a targeted injection. I also get SI joint inflammation and that can be awful!

Actually, just 5 days of an extra 5mg is rarely enough, you may need up to the full 2 weeks we talk about to get a difference. You say walking is more painful - in what way? Where exactly?

[Jones3 in reply to PMRpro]

Thank you PRRpro - I was hoping you would reply.

No they haven't done any x- rays but about a year ago I could walk for several miles with no discomfit. Maybe the MRI scan will show up something? I have had bone density checks and they don't suggest any problems that an X-ray might reveal. Now when I walk the symptoms increase the further I go. Ease off when I stop. The buttocks/thighs/calves - pretty much everywhere. It is not as if my shoulders/hands are immune to discomfit (especially when stressed which in my current situation is right up there) - but less so.

I did the 10mg in the belief you could drop down to 5mg without creating any issues. Interesting that I should try it for longer. Could I go straight back to 5 or have to taper?

I'm wondering if this has now just become a combination of ongoing PMR/ some sort of spinal stenosis/normal ageing. All I know is that it is omnipresent and seriously affects my sleep.

I've just caught Covid and my partner has been in hospital for 2 weeks after a botched TAVI day procedure. Too much information but the stress = increased symptoms.

Thanks again

[PMRpro Ambassador in reply to Jones3]

Not TMI - but very very relevant!

Dexascans won't show much besides bone density, occasionally it may reveal fractures. But this could be bursitis, soft tissue problems, x-rays are to rule out things more than rule them in.

You can be at the higher dose for up to 2 weeks and still drop back to just above the original dose.

What you are describing is similar to some of my problems and they are almost all muscular. Buttocks and legs can stem from piriformis syndrome and myofascial pain syndrome - and greater trochanteric pain syndrome might be a thought too,