Hi there I got diagnosed with PMR in April 2024. I started on 15mg Pred put up to 20mg a month later (for a month)by Rheumy which wasn’t necessary and had every side effect imaginable between 15mg and 10mg.
Once I got to 10mg in August all side effects dissipated. I am now at 7mg which I have been alternating from 7.5mg for last 4 weeks. I have been doing a lot more exercise and walking 4 kms a day (I walk very fast I am told!). I am now getting sore muscles in my legs and hammies. Wondering if this is DOMS or a flare - I’m not sure what a flare is. No other soreness anywhere but I am more tired and only sleep 5 hours a night.
Would love some advice thank you so much.
Written by
Suzanne28
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A flare is a return of the same sort of symptoms as you h ad originally. It can be due to getting to too low a dose for the level of activity of YOUR PMR or it can be due to the disease activity ramping up for some reason - stress, illness, medication, vaccinations often cause a short-term flare.
I think it is possible it could be BOTH. Your muscles suffer rather with both PMR and pred. The pred cures nothing - all it is doing is relieving the inflammation being caused by an underlying autoimmune disorder and that relieves the symptoms due to the inflammation. It has no effect on that disease process and it continues in the background, still attacking your muscles and other soft tissues like ligaments and tendons, especially where they attach to bone. This leaves them rather delicate and more liable to injury, whether trauma or simply overuse and in the latter case you often notice DOMS which can take a lot longer to recover than you are used to. It is all too easy to do a bit too much - both duration and intensity - when the dose of pred is loads and nothing hurts, plus pred tends to give us wings and if we don't watch out we overdo it.
The combo of more walking, especially fast (what's that?) and the slightly lower dose may be the reason. I'd try cutting back on the intensity and amount for a while and including rest days between walking days - do something using arms if you want to do something on those days - and maybe try some ordinary painkillers before assessing if the 7mg dose is still enough.
Thank you so much! I really appreciate your comprehensive response. I’ve always walked fast pre PMR and I think I am back to walking at my old pace which is backfiring on me!! Before I was diagnosed with PMR my pain started in my legs and hammies and I was unable to get out of bed, get out of a chair and walk around the block. I remember at that time walking up a slight incline in our street and definitely tweaking my hammie and that spot has always been vulnerable since diagnosis even though the Pred was immediate and great in that area it does get sore after too much exercise. I will take your advice and rest more thank you. It does respond to ice/heat pads and heat rub cream and panadol but doesn’t go away completely. Thank you again.
Sounds familiar Suzanne! However, exercise has also helped me A LOT -a bit of cardio, stretching and strength training (no weights yet). My solution has been gentle and often - several times a day, especially when in pain. I am (just about) accepting running, cycling and hill walking will have to wait for remission.
"In May 2013 I was diagnosed with PMR and immediately given 20 mg Pred. At the time I was 51yrs old, fire officer and ex-PE teacher. I have completed 22 marathons and well over 100 half marathons around the world. Apart from being a runner I'm also a high altitude mountaineer and climber. Just before being diagnosed I was running 50+ miles per week training for another marathon (London) and booked for a climbing expedition to Ama Dablam in the Himalayas.
Eleven months ago - in May - I was bed-bound, used a wheel chair and unable to switch on a light! I'm now on 4 mg Pred (April 2014) attended Rehabilitation Therapy Centre last year and started running again in October. I have weekly hydrotherapy and physiotherapy sessions, complete Parkruns on Saturday mornings and although slower I've managed to run 23.08 mins for the 5km. I follow a daily exercise programme, have returned to work and hope to complete the Great North Run (13 miles) and Tunnel-2-Towers (New York) this September."
I'll grant you he is unusual - but never say never. It's all a question of degree.
Thank you for posting that! I am optimistic (with occasional wobbles) that I will either be fit again or that I will accept whatever level of fitness I can get too. Being on top of the Yorkshire fells and running the dales was an important part of my life. I note skinnyjonny has a 20 year advantage! I was already down to 1/2 marathons pre PMR.
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Flare or not ?
flare
Flare-Pred increase- feeling worse
flare up
