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After two years of PMR with nineteen months on pred, I can say I'm pretty stable but not who I am.

Posted , 10 users are following.

paul45653
paul45653

I now realize that bilateral knee pain on stairs etc, is one of the last hurtles. I still have no diagnosis for the knees. Last X-ray did not show significant loss of cartilage. Regular walking is not deterred by the knees but thigh muscles limit the distance. I can understand the thighs being affected by PMR, but I question the knees. I have a Ruemy appt. On the 25th before reducing to 6.5 mg. what can I ask be done to sort out the knees as related to PMR? What are the symtoms of PMR when it gets to the knees?

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  • Kdemers
    Kdemers paul45653

    Posted

    My experience with PMR--especially when I first had it, was that every injury I ever suffered seemed to respond to the inflammation.  I had knee and ankle and foot muscle tension as well.  I have bilateral knee replacement and the new knees affected my alignment.  I had worked with a PT and all seemed better.  When PMR hit it felt like it all came back, so maybe your knees are responding to muscle pulling, or are inflammed. It is like the body remembers and the problems radiate. 

    If it all went down to my calves, feet, etc. it could go to your knees.  I did go in for some physical therapy and got some relief.

    I wish you luck.

  • nick67069
    nick67069 paul45653

    Posted

    I am relatively new to PMR, but I had knee issues for years because of the sport injury and raptured ACL. So based on that experience, I can suggest a reason how PMR and knee  problem might be related... Knee depends on the strength of thigh and hamstring muscle to function. If those are weak, knee becomes weak and loose. This can , in a long run, damage cartilage and cause pain. If you have pain on one or both sides of the knee, then most likely what is hurting is ligament connected to hamstrings.  Physical therapy and targeted excercise would/should recover most of the functionality. 

    This is my best guess. I would find a doctor that deals with lots of sports injuries and ask for opinion, after explaining that you suffered from PMR  and muscle weakness.

    • LayneTX
      LayneTX nick67069

      Posted

      Yeah, but be careful.  I had a physical therapist that seemed so good! Very sports oriented, said they understood PMR, but I believe did not. Kept asking me why I was taking Prednisone. Had me do exercises to failure, I ended up with more issues in shoulder/upper back.

      He did however help me learn proper way to squat and get up, and use my arms in better form which helps minimize pain in shoulders.

      Just be ware. 

    • EileenH
      EileenH nick67069

      Posted

      As Layne says, this approach is associated with many risks. Many physiotherapists and, I would suspect, even more sport orientated doctors are totally unaware of the restrictions that PMR imposes. Your muscles are intolerant of acute exercise and repetitive and sustained actions are both totally unsuitable for rehab in the PMR patients. The blood supply to the muscles is compromised which leads to speedy exhaustion because of the lack of an adequate supply of oxygen and nutrients - claudication in certain muscle groups is one symptom - and then do not recover because lactate and other waste products are not removed.

      The exercises you can do should be restricted in terms of weights used and reps done and rest periods are essential in between. It is often difficult if not impossible to exercise on consecutive days because the muscles have not yet recovered from the previous activity.

      Layne's physio claimed to know about PMR - obviously NOT the PMR we have! If they had, they would have been well aware it is the only form of management of the pain and stiffness. So you do need to cross-examine anyone who says that sort of thing.

      I am not saying you CAN'T exercise and train - I'm saying you have to be very careful with building up what you can do. It took me from early December to late January to get to being able to ski all morning - I still could not do a long run in one and if I had one hard morning I needed the next day to recover. Short runs interspersed with the rests on the lift meant I could ski much more as did having a day rest between ski days.

    • Kdemers
      Kdemers EileenH

      Posted

      Eileen--your precise description is perfect and everyone should become aware of what is going on in muscles, etc.  Thank you for your post.
    • paul45653
      paul45653 nick67069

      Posted

      Yea Nick. Last time in PT he wanted me to stretch my hamstrings which are very tight.
    • paul45653
      paul45653 EileenH

      Posted

      Thanks for the analysis Eileen. I'm still looking for a reliable Bowens therapist. Maybe go back to PT.

       

    • nick67069
      nick67069 EileenH

      Posted

      As usual, you are correct and I agree 100% with what you said.  I would like to add some more to this subject, but, if you dont mind, I would like to continue discussion about excercise in "my" thread, so whe people in a future look for the answers, everything is in one place...

      Do I have your permission to copy your message before commenting on it?

    • nick67069
      nick67069 paul45653

      Posted

      Not all PT are created equal... just like not all of us respond to same treatment in the same way. What works for me, may not work for everybody.  I have an excelent PT.  She has helped with recovery very much. 
  • pauline36422
    pauline36422 paul45653

    Posted

    hi paul i have put my point on another post.  that i found bowens  cured my knee pain. weather it was coincidence i do knot know but it did go after 3 treatments
  • EileenH
    EileenH paul45653

    Posted

    I'd suggest it may not directly be the PMR but possibly indirectly due to the PMR having led to poor posture and gait. I ended up in hospital with severe low back pain, dx'd as sacroiliacitis - but the pain clinic said it could be traced back to the state of my back muscles which were all in spasm and posture and gait adapted to that. The fact it is both knees would fit that too.

    My suggestion would be to start by looking for a Bowen therapist and see if they can give you any relief. I know people who have gone with a back problem - and then realised their knees were a lot better too. Or a good (probably private) physio or a sports massage therapist. These are all easily available without having to beg for a referral - and in the case of muscle problems far preferable IMHO to doctors. I was told by an orthopod that my low back pain that eventually matured into the sacroiliacitis was wear and tear and I'd have to live with it - I couldn't walk or stand for more than 1/4 hour without severe pain so it really wasn't very practical! The pain clinic doctor and physio were horrified - but orthopods are orientated on problems due to bones. Muscles don't show up on x-rays so they then conclude there is no problem.

    As nick says - they are all connected. Spasmed back muscles can cause referred pain into the buttocks, thighs and even as far down as the knees. They also put stress onto the surrounding muscles which change their position minimally to accommodate the pain and reduce it - and it can have effects as far down as the feet.

    • EileenH
      EileenH

      Posted

      PS - I hadn't seen Pat's post, we were writing at the same time!
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