PMA or Arthritis

[Caulkhead63]

How do I know if it's PMA or Arthritis? I'm tapering nicely with my pred . I have arthritis in my hands but my knees and hips are starting to ache. My hands are worse than they were but how do I know if the rest are one or the other?

[DorsetLady PMRGCAuk volunteer]

Difficult to say when there’s not a lot of info. You say you are tapering nicely, but what dose of Pred are you on now and how have you reduced to that point?

Could be arthritis poking its head up, but if it’s both knees and both hips, that does sound very much like PMR also.

Have you tried painkillers for arthritis - and do that help? If so, it might be that; if not then it probably is PMR flaring. Maybe try the flare protocol as described in link to see if that helps - and dropping back to just above current dose.

healthunlocked.com/pmrgcauk...

But more details would help..

[Caulkhead63 in reply to DorsetLady]

I started off at 15 in 2022 . Been VERY slowly reducing. Then x-ray showed arthritis in my hands about 6 months ago. I'm starting to ache in both knees and hips. Pain killers help but pain doesn't go completely

[DorsetLady PMRGCAuk volunteer in reply to Caulkhead63]

What dose are you on now? Your idea of very slowly, might not be the same as ours… 1mg a time, 0.5mg a time, slow tapering plan?

[Caulkhead63 in reply to DorsetLady]

I'm on the slow tapering plan. I'm down to 6 . I've had no problems up till now

[DorsetLady PMRGCAuk volunteer in reply to Caulkhead63]

Okay… but just because you have been okay up to now, doesn’t mean it isn’t PMR… and if painkillers don’t help then maybe you have gone a tad too low on Pred. That can happen no matter how slowly and carefully you go.

As you get lower on the Pred, there is less ‘spare’ to play with - and at 2 years your PMR may still be a lot more active than you think.

You aren’t reducing come what may to zero, all you are doing is managing your PMR until such time as it goes into remission… and sometimes you go below the level of Pred your illness actually needs on a day by day basis. When that happens you may need a temporary increase to get the inflammation that has been allowed to build up back under control. Hence the flare protocol.

[Caulkhead63 in reply to DorsetLady]

So shall I go back up slightly and see if that helps?

[DorsetLady PMRGCAuk volunteer in reply to Caulkhead63]

My advice would be to follow the protocol in the link I sent. Just going up by an odd mg doesn’t always work..

[Caulkhead63 in reply to DorsetLady]

Thank you x

[DorsetLady PMRGCAuk volunteer in reply to Caulkhead63]

As others have suggested X-rays would be sensible as well.

[suzy1959]

I never found any painkillers worked on my arthritis , 3 of my joints were hurting at once and I was on quite a high dose of pred. So the only way to tell it was arthritis was to have x rays of the joints. It might help to get those just to be sure whether it is OA or not.

[Caulkhead63 in reply to suzy1959]

I was thinking that. My x-ray department is a walk in. Do I still have to have a referral from the doctor do you know?

[PMRpro Ambassador in reply to Caulkhead63]

You do usually.

[Caulkhead63 in reply to PMRpro]

I'll ring my doctors surgery. Thank you

[Bcol in reply to suzy1959]

Co-Codamol works well on my OA and before Pred Naproxen was also good. They were/are the only things that worked/work for me.

[Doraflora]

this sounds like my situation, Caulkhead63.

I’ve had a swollen & painful knee for about 5 months now & I’ll get the ultra sound results on Monday. I really don’t know if it’s PMR related or not.

But lately my hands are hurting a bit & I’m getting aches down my hamstrings. PMR or arthritis? But I’ll wait & see what my scan results show & then see.

I’m currently on 2.5mg of Pred, having done an extremely slow taper by 0.5 a time. In fact I’ve been on 2.5 for several months now. Whilst I’ve got these little aches & pains etc going on, I don’t intend to decrease any more atm.

Ive had PMR 4.5 years now and I realised a very long time ago it isn’t a quick fix - unfortunately

Just don’t rush your tapering: 0.5 mg each time is key.

[Caulkhead63 in reply to Doraflora]

That's what I'm doing 0.5 at a time. I've managed to get a doctor's appointment for next Friday! Which is amazing for my doctors surgery! So I'll see what she says about x-ray on my hips and knees. My hands are worse as well

[PMR_sufferer1]

In regard to your hands my experience is that during my PMR journey I had stiff fingers especially in the morning. Both hands and all my fingers were stiff but no swelling.All I am saying I think is that stiff fingers can be part of PMR.

[Caulkhead63 in reply to PMR_sufferer1]

I had x-rays on my hands a month ago. The doctor said it is arthritis. I have a lump on my right hand under my thumb as it goes into the wrist. I think it's getting bigger. I'm seeing the doctor on Friday.

[EngineerMatthew in reply to Caulkhead63]

Exactly what the old Indian Rheumy did. Maybe I had both PMR and RA? Hips are worst.

[EngineerMatthew]

my third Rheumy diagnosed arthritis after being treated for 3yrs PMR. Good luck

[Andos16 in reply to EngineerMatthew]

Hi EM, my 2nd rheumy said RA after 18 m of Pred doe PMR! First rheumy was arrogant but or appears a v grey area.

[EngineerMatthew in reply to Andos16]

My first two were women. Both very nice. I fired the first one because she was just too young and not very bright. 2nd one was a 40yr old DO, not MD. Big improvement but just kept me on prednisone until my AoneC got too high and cut me off cold turkey. That was hell. Without prednisone, I just wanted crawl in a bottle. I quit my high paying job. Pain just made my life hell to the point I just did not care if I could pay bills or not. Every Rheumy Said they don’t do Short Term disability ????. Last one was an old Indian guy…said that it is not PMR but RA. The drugs he tried made liver enzymes go way up so I just quit taking any RA drugs. Now I use legal cannabis. It really helps a lot but can’t stand being stoned all the time so just use it for my exercise days. I can now walk a 12 minute mile….not bad when 6months ago even getting out of bed to use the bathroom was agonizing. I had two back surgeries so I fully comprehend serious long term pain. Now trying to reduce cannabis for just CBD oil but the RA in my 60yr old hips is making it hard. Hands, still dropping stuff.

good news is my cardio is the best in maybe ten years. Liver should be healing too because I no longer drink ever or take over the counter pain meds. That Aleve made my kidneys hurt after long term use when they stopped all prednisone.

This is going to sound harsh but I mean it with the most sincerity and love, “keep moving or die; Motion is lotion”

I hate prednisone but still have to use 5-15mg for flare-ups maybe once every other month. Difference, RA is in all my joints but Flareups seem to be in my muscles too.

Some of these RA drugs are $5-6k a month without insurance. $60-72k a year

$100 bag of cannabis will last me 18 months but ashamed to go anywhere smelling like a hippy on my workout days.

I could not exercise on long term prednesone. I got exhausted just walking 50ft. So grateful they legalized this stuff. I use to look down my nose at people that did it. Now I wonder why every grouchy old person in moderate to severe pain does not give it a try?

[Andos16 in reply to EngineerMatthew]

I definitely agree with Move it or Lose it!!

Can't believe they made you do cold turkey on Pred.

[PMRpro Ambassador in reply to Andos16]

Me neither - it could have killed him.

[PMRpro Ambassador in reply to EngineerMatthew]

"just kept me on prednisone until my AoneC got too high and cut me off cold turkey."

Was she trying to kill you?

[Tonynatella]

is PMA progressive muscular atrophy?

[DorsetLady PMRGCAuk volunteer in reply to Tonynatella]

Think it’s a typo -should read PMR.

[Doraflora in reply to Tonynatella]

Polymyalgia Rheumatica

[arvine]

I would like to know the answer to that question as well, I too am down to 4 mgs pred, in process of tapering to 3 1/2, , but have osteoarthritis confirmed by MRI s and exrays, so pain all over, last while severe in hands, and hip( groin pain etc) , also no relief from taking tylenol( which is apparently only pain med can take with prednisone) , and as I have posted , chronic pain getting me down, live alone, barely managing daily chores, basics,

[Caulkhead63 in reply to arvine]

Yep that sounds like me. I live alone too. I'm seeing the doctor on Friday and hopefully can have x-ray s to check. Just to put my mind at ease so at least I'll know what's what.

[arvine in reply to Caulkhead63]

Yes hope you get some answers and advice as how to manage pain, be interested in hearing outcome of your results

[Caulkhead63 in reply to arvine]

I'll let people know

[Doraflora in reply to Caulkhead63]

It’s so good you’re seeing a doctor! I hope you get something sorted.

I have to say though, I am getting the results of my ultrasound on Monday and was given the option of a face-to-face. Wonders will never cease🤣

[Caulkhead63 in reply to Doraflora]

LoL! I only rang yesterday and she said next Friday! I was shocked!

[Doraflora in reply to Caulkhead63]

Wow! Well very good luck for a good positive appointment

[Tonynatella in reply to Caulkhead63]

I will pray for you and your future comfort with this challenge.

[Tonynatella in reply to arvine]

Sorry to hear you are suffering so badly. I will pray for your comfort through this journey.

Tony

[AtopicGuy]

Do you have osteoarthritis or rheumatoid arthritis in your hands? OA is wear & tear of the cartilage and other tissues that make up the joints where bones meet. RA is an autoimmune disease, where the immune system mistakenly attacks the same tissues, making them inflamed. RA usually responds well to steroids, while OA only does if the worn structures have also become inflamed.

Polymyalgia rheumatica literally means 'inflammatory pain in many muscles'. Like RA, PMR is an autoimmune disease, but this time it is the blood vessels serving the larger muscles that are mistakenly targeted, not the joints. Steroids suppress the immune system, reduce the swelling, and restore optimal blood-flow. This eases the pain, stiffness and fatigue.

Confusion arises because PMR-pain is often concentrated in the large muscles that surround and stabilise the major joints, especially the shoulders and hips. Working out whether the pain is coming from within the joint itself, or from the nearby muscles, can be tricky. It is not helped by the fact that PMR is much more common in the over-60s, so it is quite common for patients to have some signs of OA and/or RA at the same time.

[Caulkhead63 in reply to AtopicGuy]

On my GP medical records it says osteoarthritis. On my right hand below the thumb as the hand goes into the wrist there's a hard knobby lump which showed up on x-ray. It's painful and I think it's getting bigger! I need to wear a support glove if I lift a kettle/ saucepan

[Smithie49]

Hi there. Your arthritis sounds very similar mine - thumbs getting really bad but knees suddenly causing problems and hips achy. I have been on methotrexate since Jan so trying to slowly reduce pred. I'm now on 6mg - came down from 6.5 at beginning of Oct - but think it may be too low. I'll give it another week or so in case the aches are adrenals kicking in or yet something else. What a conundrum. I wish we could be plugged into a diagnostic computer like modern cars 😀

[Meriadoc]

I'm increasingly thinking that PMR is just another convenient 'label' for a range of problems. I was eventually diagnosed with PMR, but only after consulting a private GP. GP surgery then put me on short course of Prednisolone, which made it worse, before another GP gave me NICE guidelines to follow. Waited 12 months to see a rheumatologist, who just confirmed PMR, but suggested I see a neurologist for other symptoms of pain and tingling in my feet. I have an appointment with a neurologist in October 2025! Symptoms worsening, but GP surgery just keeps telling me to increase prednisolone, which doesn't improve pain in feet and leg/hip. Painkillers don't work. I think PMR is just being used as a way to keep people out of the surgery and avoid any other referrals for tests. Any medical advice is unavailable on the Isle of Wight it seems!

[PMRpro Ambassador in reply to Meriadoc]

You do seem to have a pretty useless lot there!! They do have access to patient.info articles amongst other that would tell them where that lot was wrong! Though at least you have something that could be improved with a dx of PMR and a script for pred. With fibro they say it because they can also claim there is nothing to be done ...