PMR flare up

[Odosmum]

Looking for some PMR wisdom here.

Long story cut short - I had a NSTEMI (small they say) heart attack at the end of August, followed very quickly by Pericarditis, which was far worse. Part of the treatment was a course of Colchicine tablets - an anti inflammatory usually prescribed for gout, but found to be effective for pericarditis. We'll gloss over the effects they had on my insides.

Anyway, colchicine stopped last Monday and since then I've developed a painful shoulder girdle, which is not relieved by my usual painkillers - paracetamol and cocodamol. I'm suspecting a PMR flare-up, although it has been pretty quiet for 2.5 years now. I've tried to give up Prednisolone twice in that time, unsuccessfully, so am stable on a 0.5mg daily dose.

I also have Rheumatoid Arthritis - diagnosed some 30 years ago - and that is stable with daily Leflunomide and fortnightly Adalimumab. I don't routinely take anti inflammatories. I've noticed some arthritic issues in my fingers too since the colchicine stopped.

Do you think that my symptoms are down to the withdrawal of colchicine? Or am I having a flare-up? I have had far less of my usual arthritic pain during the months I have been laid up with pericarditis, which I attributed to the resting, but now I'm not sure.

Any wisdom greatly appreciated. I do have emergency pred (I usually travel a lot) so I could try upping it to 5 mg for a few days, but would rather put up with it and see if things settle down again.

Thanks for reading.

[PMRpro Ambassador]

Hmmm - pass!!!! Not on my reading list! However - did you know that TAKING colchicine can cause gout? I can imagine the gut effects - I had read all that before OH saw the GP when he had textbook gout so knew that with his history that whatever was used, colchicine was NOT advisable for him and she gave him a short course of pred which was infinitely preferable.

But of course, all you can find about colchicine relates to its use in gout and a couple of the papers that led to it use in the ED for pericarditis. Sorry.

[Odosmum in reply to PMRpro]

Thanks anyway, PMRpro. Apparently the use of colchicine is quite new and the hospital is a University hospital. My consultant is a professor and the chap who did my angioplasty/stent is also a professor! There are several in the Cardiology department. My GP spoke to them about the colchicine side effects and they doubled my Omeprazole, prescribed 300 mg Asprin for 4 weeks and halved the colchicine, which helped enormously.

[Odosmum in reply to Odosmum]

Forgot to say that I didn't know about colchicine causing gout. I wonder whether it's possible to have gout in the shoulder girdle? Hmm..........

[PMRpro Ambassador in reply to Odosmum]

You can but it is very rare. But we know you're a rare bird!!! 😘

[Odosmum]

I think rare should be my middle name 😁😁😁

[Odosmum]

I thought you might like to hear what has happened since I last posted about i-lateral shoulder pain and whether it might be a flare.

Well, I decided to stick with my 0.5mg of pred as the pain wasn't so bad. A few days later, we had a longish drive which left me with neck pain, so DH was rubbing Voltarol (ibuprofen) gel on my stiff neck. As soon as he touched the big neck joint (can't remember the name) I nearly hit the roof. It was from that joint the shoulder pain was coming. A good few applications of gel sorted the shoulder problem.

I am accustomed to my neck causing mechanical pains around my upper back, but the thing is, before DH touched that particular joint, I was unaware that there was a problem with it - it was only the shoulders. Anyhow, problem is fixed and I shall be seeing my back man (Osteopath/Physio/Accupuncturist - I love that man!) in the new year.

In the meantime, Rheumy has sent for me unexpectedly. I phoned on of the Rheumatology team to let them know about the heart etc and she did say he would probably want to see me. He's beaten Cardiology though - I'm still waiting for them.