Does prednisolone help/mask other inflammatory diseases?

Hello Wpg!

Welcome! Your GP is quite right that prednisolone is helpful in other inflammatory diseases including arthritis. However, the big difference is that with most other forms of arthritis the effect takes some time to be noticed but in PMR the patient feels the difference within a very short time, typically a reduction of up to 70% in the severity of the symptoms within literally a few days. Some patients feel the difference within a few hours! I took my first dose at 10.15 in the morning having fetched the tablets from the chemist and at 4 in the afternoon I walked downstairs normally - i.e. not like a toddler :lol: - for the first time for years. I had had the symptoms for 4 or 5 years before diagnosis.

It does sound to me as if you have a sceptical GP there. I, too, had bad lower back problems but after a few months of prednisolone at above 10mg per day most of the back pain has improved greatly and I can now walk fairly well when I have the energy. In your place I would be asking if I could try some physiotherapy for the back problem as that was something that helped a lot for me even when I was having to get through the PMR with no other treatment.

I've just realised you refer to Tylenol - so you are in the USA, I assume? A taper of 1 mg every 2 weeks is NOT a gradual taper - as you have seen from others experiences. Most doctors in the UK would look at 1 mg a month at best and that is really good going. And I don't think many of us find that normal painkillers are of any great help with PMR pain - I use ibuprofen on occasions but \"before steroids\" it really didn't cut the mustard at all and I needed a lot to get any benefit at all. Now I do find it will help with a stiff muscle but even the top dose I can take only dulls the pain, never relieves it altogether, like it does with a headache. I may have other things going on - but if it is it is a very minor bit of osteoarthritis and lack of exercise! The pains that one rheumy claimed were osteoarthritis disappeared completely within less than 2 weeks of taking pred and from my research I really don't think that that would have been so if it were really arthritis.

Good luck with finding a new doc - do hope it's a more sympathetic one! But do try some physio or medical massage. I also found Pilates was very helpful in getting the back pain and discomfort under control - there are a lot of the exercises which are the same as the ones used by physios for back problems. Keep in touch,

EileenH

Hello

Yes steroids do mask other things when they are on high doses and I think perhaps some people forget by the time they get to a low dosesage they had these things before

They are also used for lots of other illnesses my sister in lawa was ill in 2002 at exactly the same time my PMR started though she was much and still is iller than I am She has Polymysyotis we both had lots of tests though she was hospitalised for hers and we both ended up on steroids !! I had 20mg for my PMR and she had 70mg as her imune system was attacking her muscles not with pain but weakness and her heart and her digestive muscles werent working properly She is now on 6mg of prend and methotrixate I recovered early 2005 ( so I thought !!!!) for it to come back late 2008 !!

I do take other painkillers I do get headaches ( I am very allergic to some perfumes and smells and can be hit like a bullet with a headache if it happens ) I also figure that at 62 I will probbly have a few aches and pains anyway !!

Your reduction seems very fast to me The first time I was textbook and went from 20mg to 1mg in a year then maintenance of 1mg for a year

This time I have been on a rollercoaster now 2 years ( almost down the line ) I am on 5.5 but was around this 12mths ago then up to 15mg in Jan

Hopefully you will now get a Dr who understands My Dr checks me 2 monthly with blood tests but says listen to your body and the most important thing is how you feel I am also always given a spare blood test form to go away with in case I feel Im having a flare up

Keep reading and review your reduction programme with others The more you read you realise how different we all are with the same illness even me with 2 bouts so different so a set reduction programme cant suit everyone Was your previous bout of PMR similar ?? This time around I am keeping much better records of bloods doesage flare ups etc

Best wishes

Mrs G

I too cannot walk 100 yards then have to sit,I was recently diagnosed after MRI scan as Spinal Canal Stenosis and was told I no longer have PMR funny that,! I still have muscle pain especially shoulders I also have O . A. in hands and knees lucky me !!! I have been put on the waiting list for a spinal op. and at 76 yrs not too happy about that, and scared stiff . Joan T.

crawf

email mrs k - you have the email or email me on this site via the pm shown at the bottom of the page.

Thank you to all of you for your replies.

Eileen H. With both bouts of pmr I felt a lot of relief with the steroid within 12 hours. The first time my ESR was 90 and I was feeling I would soon be in a wheelchair. I had never heard of pmr. My GP (the one I had before the present one) started me on 50 mg of steroid and it was like a miracle the difference it made. I was flying around feeling like washing walls, baking pies, etc. where before I could hardly get out of bed or dress myself or sit down or get up or do stairs.

I did go for one session of physio three months ago but my back was too sore at the time and exercises made it worse. I do plan to try again soon and maybe massage. Re the Tylenol - I am in Canada.

Mrs. G. My previous bout of pmr was similar except this time I recognized what it was and got the steroids before I was in as bad a condition as the first time. I had been off the steroids for a year. Like you, I am keeping better records now.

Crawf. Thank you for sharing your back problem. I am interested in hearing from others who have this trouble when walking as some seem to be able to walk much farther. I am also 76 and sympathize with your facing a spinal operation. Let us know how you are getting along.

[quote:17e28602e3] I am interested in hearing from others who have this trouble when walking as some seem to be able to walk much farther.[/quote:17e28602e3]

Hallo wpg. I am 78 and I, too am going round the PMR route for the second time. Last time it was all in my upper body and responded magically to 30mgs. That was in 1999. I think the thinking on starting doses had changed and the usual, now, for those who \"only\" have PMR is 15. Don't know whether the difference acounts for my very different symptoms.

But this time, like you and, I think, Mrs.O (sorry if I've got that wrong) I find walking any distance very difficult. I find supermarket trolleys a godsend. It varies from day to day but I think in disbelief of the days when I showed Great Danes and ran round the ring with them and took them for walks before going to work and when I got home and thought nothing of it. But I do try to move about as much as possible even on the bad leg days on the use it or lose it basis. With all the variations of symptoms, reactions and outcomes I stick to the belief that this, too, will pass! SOON please. Good luck BettyE

Like you, Betty, I loved walking and walked for miles just about every day. I find it frustrating that, now, I can't walk far at all. My legs can feel weak but I console myself with the fact that, before treatment, I had to give up yoga and weight exercises because of loss of mobility. Since Prednisolone, I am able to do the gentler yoga and the lighter weight exercise. My GP is lowering my dose very gradually, depending on the results of my monthy blood tests. I am hoping that I might get back to being almost normal for a 75 year old. Madge.

Hi Wpg, Crawf and Betty

With regard to spinal problems and PMR/GCA, in the absence of a particular known cause I will always remain convinced that my PMR started with an injury to my already damaged spine (spondilolisthesis: slipped vertebrae) as the first symptoms were identical to previous severe back-related events over the years, although I never had the leg or arm involvement that has come with PMR. I do however now wonder how much of my current pain is linked to my spine rather than PMR.

You're right Betty in that although pre-PMR I used to walk miles, I'm unable to walk very far even 4.5 years down the line with PMR and having reached 1mg from 40mgs. There has been some improvement over the last couple of weeks in that I've managed to walk for half an hour without the usual sit-down half way which is now leading me to wonder whether the steroids have, in fact, been aggravating my back muscles following the long-term use.

Crawf - I do sympathise with your worries at having to face spinal surgery. I have some narrowing of the spinal canal but have managed to avoid surgery up to now. Do you have nerve damage and sciatica as a result of the stenosis? They do seem to be much more advanced with spinal operations these days and I do wish you well.

MrsO