Hello, Does anyone else with PMR have problems with their Achillies tendons? I excercise and do stretching but they get very painful.

[Loco99]

[Hidden]

Hi Loco,

I have had PMR for just over 2 years and feel that I am recovering well. At present, I am on 8mg of steroids. For the past 6 months I have had, on and off, painful tendons - ligaments in elbows, shoulders and knees. These side effects began after I had been on prednisolone for approx 18 months.

One of the side effects of pred is damage to the soft tissues of the body and I believe tendonitis is common after one has taken pred for quite a while. My symptoms come and go, and I think it is important not to overdo exercise when the symptoms occur, but to rest and support the joint until it recovers.

I do not practice stretching exercise, but rely on walking and general housework to keep reasonably fit.

Pats

[Loco99 in reply to Hidden]

Thank you for your reply. I have had PMR for three years and my steroids have just been cut down from 4mg to 2mg. At the moment I'm having good and bad days but the tendons have been gradually getting worse so what you say about steroids and tissue damage makes sense. I do a long walk twice a week and also do general housework to keep mobile.

[HelenJC]

Hi Loco

I have had PRM since May last year, and been on steriods since end of June. I have just cut down today from 10 to 9mg.

Whilst I was being diagnosed the physio recommended me to do some "exercise on prescription" to strengthen the muscles and support my hip joints, which are showing signs of my age (nearly 65). Pressure of work meant I only started this in the New Year. I have had trouble with my left hip for some time (since before I started the gym), which has been getting progressively worse. I did not feel this was PMR as it was OK first thing in the morning but got worse during the day - some days I can hardly walk! - whereas the PMR pain used to wake me up early in the morning. My doctor thinks is it bursitis in the hip and has given me some anti-inflamatory cream to rub on. If that doesn't improve things it will be a steriod injection in the joint (ouch!) I also have pain in my right wrist (too much mousing/keying?). I am now in the position where my bones would benefit from some impact exercise (in moderation of course) but the bursitis would not!

I try and walk the dog twice a day, but am not managing to make it to the gym often enough to be benefitting from that.

I only add this information to the discussion as Pats said she believes damage to the soft tissue is a side effect of Pred when one has been on it for quite a while - not sure if 7½ months counts as quite a while.

Helen

[Hidden in reply to HelenJC]

Hi Helen,

Yes, I understand what you're saying - why did I have damaged tendons etc after approx 18 months, whilst you have been subject to this complaint in a much shorter time? Answer, I can only guess. We all have our own strengths and weaknesses, therefore does it not follow that side effects will occur at differing times in our own particular treatments?

Myself, I have given my body an easy ride since being on pred because I have found from bitter experience that pushing myself just landed me in trouble - it was simply not worth it, therefore, I have gone easy and paced myself as much as possible.

OK, I still have a fat midriff - scrunchies, which I did regularly pre PMR, just wrecked my shoulders so I gave up. I have lost muscle mass in my lower legs and arms, but once I have put PMR to sleep using pred, I can, hopefully start gentle exercises again to regain my former glorious physique...........Haaaaaaaaaaaaaaaaaaaaaaaaaaa!

Pats.

[Celtic PMRGCAuk volunteer]

Hi Loco99

"my steroids have just been cut down from 4mg to 2mg."

I do hope that wasn't a direct reduction from 4mg to 2mg, and that you went via 3mg first, pausing at each level for a good couple of months in between? It's very important to reduce in very small steps at these low levels of steroids in order to avoid a flare in inflammation.

As you mention having "good and bad days" still, it might be an idea to avoid the "long walk twice a week" and instead do a shorter daily walk.

[Annodomini]

Hi Loco

I could have written your query myself. I had tendonitis years ago in my left Achilles but that was remedied with ultrasound treatment. However, in the last few months it has blown up in both feet and it really hurts to walk as far as the bathroom first thing in the morning. Both tendons are thickened. I'm on 3mg pred at the moment and am due a blood test as soon as I remember to book it! I am glad you asked the question because the answers apply to me too.

Thanks

Anno

[Loco99]

Thank you everyone. I also have a problem with my right hip and get pain in my ankles, knees and thighs as well as the Achillies tendons. The tendons are bothering me the most at present. I am taking the leap from 4 to 2 mg and seem to be surviving so far with the help of the occasional dose of Arcoxia. I am seeing a biokineticist who has given me strengthening and balancing exercises to help with all of the above mentioned problems. Like Anno I hobble around first thing in the morning until the tendons in my ankles loosen up a bit. I am supposed to do foot stretching exercises before I get out of bed but invariably forget. It is so nice to be able to discuss PMR with others who understand the condition.

[Celtic PMRGCAuk volunteer]

Hi again Loco99

Your painful tendons could be caused by bursitis which is linked to PMR and can cause pain in the ankles, knees, thighs, hips. I feel very concerned for you having reduced directly from 4 to 2mg - the percentage reduction gets higher the lower we get on the doses and your adrenal glands will be battling to recover from being suppressed by the steroids. If it was me I would prefer to control the inflammation with a higher steroid dose rather than add anti inflammatories into the mix - too harsh on the stomach. I do hope the stretching exercises will help with your pain.

[Loco99 in reply to Celtic]

Hi Celtic, thank you for your concern. Having read up on bursitis, I think you may be right. If things don't improve soon, I will consult my family doctor. The drop from 4-2mg was decided upon by my rheumatologist, he seems to think that anti inflammatories are the lesser of two evils. All of my blood tests have been normal for some time so he feels that I will be able to handle the steroid drop. I suppose it is all a matter of trial and error. If I don't improve then he will have to up the steroid dose again.

[Loco99]

A report back on my tendon problem. Despite exercise and stretching, the problems with my ankles continue. I went to the rheumatologist last week and asked for his opinion, he thought it was unlikely that PMR was causing the problems and sent me for x-rays and ultrasound. The x-rays revealed that I have calcaneus heel and achillies tendon spurs. The ultrasound showed they are not PMR related. It is a great relief to know the cause of the pain and swelling. The next step is to see a podiatrist. There is a lot of information on the web about heel spurs and I'm hopeful that if I am careful, I can keep my feet and ankles from getting worse.