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Does anyone suffer fron osteoarthritis in the hip as well as PMR?

Posted , 10 users are following.

gillian82551
gillian82551

I was diagnosed with ostearthritis in the hip 3 years ago - but because I developed PMR around that time I have never experienced any pain from the hip due to it being masked by the steroids. However, 2 weeks ago my Prednisolone strength was reduced to 10mg daily from 15mg. I am now experiencing terrible pain in my hip and leg ( due to the arthritis which I was totally free from before.) I am sorely tempted to up the dose!. I am due to see my doctor next week about this. Cannot take any other anti inflammatory drug whilkst on the steroids. Would be interested to know if anyone alse has had this trouble?

0 likes, 19 replies

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  • Anhaga
    Anhaga gillian82551

    Posted

    Are you sure it's not mostly PMR caused by that very large drop of 1/3, 15 mg to 10 mg?  Recommendation is never to drop by more than 10%.  You've dropped three times that amount.

    You probably should increase your dose, not because of possible OA pain, but because it's most likely your PMR infalmmation is no longer properly controlled.

  • Ouzel
    Ouzel gillian82551

    Posted

    You need to consider that the PMR is what was causing you hip pain to begin with as it can cause significant hip pain (unilaterally or bilaterally), because you said the diagnosis came about the same time as you developed PMR. Lots of people have significant degenrative changes on x-ray and don't necesarily have much in the way of symptoms.  Anyway, I agree with Anhaga that you've cut your prednisone way to fast or too far (or both) so I'd go back to the dose you were pain free and go from there.  The "terrible pain in my hip and leg" doesn't sound so much like arthirits anyway as it would be a dull ache, exacerbated by walking, etc. (I'm an orthopedic surgeon BTW).

    • Loulie
      Loulie Ouzel

      Posted

      Oh, I wish my orthopaedic surgeon understood the ramifications of PMR, then I might have some real diagnosis. As well as PMR, I have spinal stenosis and have lower lumbar disc problems. Have had steroid injections in spine and hip but they did not work. Am on 20mg of Pred but I suffer from leg pain and aching in lower back, I find walking difficult and have numb feet. (I sound like a wreck, but not so long ago I was very fit). Consulted with an orthopaedic surgeon at a spinal unit in UK but he seems to think he cannot operate and anyway due to constant UTIs would be unwilling to try. Not at all sure where this leaves me, except hurting, feeling on the scrap heap and a bit alone. I guess you have no magic wand to wave, do you? 😞
    • Ouzel
      Ouzel Loulie

      Posted

      Sorry Loulie... sounds like you're having some real issues.  Perhaps when you get the PMR more under control (lower prednisone doses) maybe your risk for complications after spinal surgery would be lower as well?  I'm not familair with UK referral patterns but I would suggest you consult another well thought of spinal surgeon for a second opinion.  And if the answer is the same then perhaps they'll have suggestions on how to make your life more tolerable.  Good luck!

    • Loulie
      Loulie Ouzel

      Posted

      Thanks Ouzel. Yes, I had forgotten that prednisone was also a barrier to operating. Hey ho! I will re-address when my dosage is lower. Thanks.
    • EileenH
      EileenH Loulie

      Posted

      10mg isn't a barrier - I know a few people who've had hip replacements on pred, at least one was on 10mg and subsequently was able to reduce and get off pred once the hip pain was gone. It was almost as if the hip pain fed the PMR.

      If one surgeon won't agree - shop around because it is their individual preferences and prejudices that are important. One may not - another will.

    • ptolemy
      ptolemy EileenH

      Posted

      I think most surgeons will operate at 7.5mg of pred or lower, but you must not take Methotrexate it seems. 
    • ptolemy
      ptolemy EileenH

      Posted

      I am not really sure why, I suppose it is more directed at people with RA as they often need replacements. It may be that surgeons are being puritanical and as you are put on some pretty hefty drugs during hip replacement, antibiotics, strong opioids, blood thinners for example, they don’t want things interfering with them. I will try and find out. I have heard that some surgeons ask people to stop taking glucosamine even. 
  • adette01750
    adette01750 gillian82551

    Posted

    Hi Gillian,

    yes I have polyarthritis and bursitis of the hip as well as PMR so have had excessive pain to, and since steroids 4weeks into them I have had no pain in my hip either.

    You may have dropped too much, I think it's 10% drops only from 15mg so I would go up to 15 and when settled and pain free do a 1.5 mg drop and see how it goes. There is a slow reduction regime others follow on this forum and most people find that works for them. Good luck.

  • ronald39523
    ronald39523 gillian82551

    Posted

    Hi. I have not had hip problems bur I can't help thinking that a reduction from 15 to10 in one move is far too much too fast. I am obviously no expert but I would have thought a 1mg per day reduction over a period of weeks would be better. R

  • Loulie
    Loulie gillian82551

    Posted

    Yes Gillian, I have hip and spine problems (arthritis and disc issues) so understand completely your confusion about what is arthritic pain and what is PMR. I always put it down to arthritic pain but since finding this forum, am now not so sure as everyone seems to think PMR is the culprit for most pain. It is hard to differentiate the difference between the two.
  • ptolemy
    ptolemy gillian82551

    Posted

    Hi Gillian, poor you. Are you saying you have been on 15mg of pred for three years? Or have I misunderstood. The aim of the pred is to sort out the PMR not the osteoarthritis, you should not be increasing the dose to sort it out, but use other pain killers if needed. I sympathise as I have severe osteoarthritis in one hip and need the hip replaced. I agree the pain can be pretty horrendous (not mild!!!). I am currently on 6mg of pred. As the others say the drop from 15mg to 10mg is pretty drastic and could cause all sorts of probems.
  • dan38655
    dan38655 gillian82551

    Posted

    I'm going on almost thre years with PMR, and I can say that the bursitis pain in my left hip can be quite severe, enough to prevent normal walking.

    The occurrance of this pain is quite sensitive to my pred dosage level.

    I'm currently at 4mg/day. The bursitis, when it occurs, usually sets in late in the day. It gets better over night, while most of my other symptoms worsen!

    I take the 4mg of pred first thing in the morning, which seems to be the most effective at reducing my daytime fatigue symptoms.

  • EileenH
    EileenH gillian82551

    Posted

    That drop was far too big for a PMR patient - never more than 10% of the current dose is recommended and even that can be too much for some people. It is also possible there is an element of bursitis - the pain can be very similar to OA in the hip.

    If it were me I'd go back to the 15mg and then reduce 1mg at a time. Particulalry if, as you imply, you have been on 15mg for the last 3 years. Even so, a 33% drop is ridiculous - it may work for a patient who has only been on pred for a couple of weeks. After more than a few months on any dose of pred you will struggle with large drops.

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