Can PMR symptoms be on mainly one side?

Hi Fortyniner, I have pain on both sides, but the pain on my right side is much worse than my left. I hope that helps you. Think positive and try to smile ☺️

Hi Fortyniner,

My Pmr pain is definitely mainly in left hip and left shoulder, but when I had stiffness, it was all over.    I had pain in my right toe joint, and for a short period and had pain in right hip for a short period.   My leg thigh muscles were very weak on both sides.

Pain is usually on both sides, but once in a while one side may be hurting more then other. Sometimes, because of the muscle weakness, it can cause other parts of the body to hurt... example is that if one side of the hip area is more tender then other, it may cause lower back and/or knee problems, which are not directly caused by PMR.

As far as reducing while having pain, the question is why would you do that? You are taking pred to manage inflammation. If you have pain, most likely your dose is lower then what you need.  It makes more sense to increase dose, rather then taper down.

There is no MUST about it - but it is generally an all-over disorder. It is very unusual to have one side that is pain-free and the other bad - and if that is the case it should trigger the question "Is this something else?". A common reason for pain and stiffness being far worse on one side than the other is myofascial pain syndrome which is more common in people with PMR. It is caused by the same inflammatory substances as PMR except they are concentrated in trigger spots which can be felt as hardened inflamed knots of muscle fibres in the larger muscle groups. They often form in pairs on either side of the spine, in the shoulder muscles, about rib level and in the lower back, where the baby's dimples are. They lead to the muscles tightening and eventually spasming to try to prevent further pain. That can also irritate nearby nerves and lead to referred pain - sciatica is the result from the lower back (doesn't have to be disc problems, muscles will do it too) and also pain in the ribs and in the neck up into the head.

If 7mg is allowing pain to develop - you have probably gone a bit too low. You aren't looking to get off pred but the lowest dose that deals with the inflammation. 

Is this the same rheumatologist who diagnosed PMR originally? If so - have they changed their mind? Were the symptoms only on one side at the start? They can't have it both ways! But it is perfectly possible that this is a starting flare and it does often seem to start on one side and then progress if it isn't treated with pred. It all depends on how soon the pred is used in that case.