Fibromyalgia or PMR?

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My friend's wife, in her sixties, has fibromyalgia or does she?  I worry because she is taking 800 mgs a day of Ibuprofen, just as I did before diagnosed with PMR. 

Elaine, you mentioned the dr who regretted naming this disease.  Could you advise on the differences of PMR and/or advice to someone with fibro diagnose?  I barely know this woman and have not talked to her about it yet.  She has had shots for shoulder injury, as did I before PMR.

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  • Posted

    Longterm relatively high dose ibuprofen is not to be messed with - it can cause gastric irritation and potentially bleeding which can be severe. Does it actually help her? I would be surprised if it did for fibro and it would probably only take the edge off PMR. 

    Did the injection for the shoulder problem improve any of the other symptoms? That is often a good indicator - PMR has been diagnosed because someone had steroid shots for shoulder pain - and everything else improved too! 

    Unfortunately the symptoms do overlap a lot - even down to the trigger points if you have myofascial pain syndrome with your PMR! Before I was diagnosed I wondered which it was - I had several places that seemed like trigger points but not enough to qualify for fibro (must be 11 out of 18 and I scored about 9). 

    https://www.mayoclinic.org/tender-points/img-20007586

    shows them - and they are exactly the same on the back as for MPS. I also had tender spots on shins and ankles - unusual but others have mentioned it. My large muscles were tender too. And my skin felt as if I had flu. 

    When you look up differences between fibro and PMR you often find they say bladder problems, fatigue and difficulty sleeping are part of fibro - but they are also part of PMR.

    The biggest difference between fibro and PMR can be used to rule one or other out: the inflammation factor and the dramatic response to a moderate dose of pred. Fibro is NOT an inflammatory condition so the blood markers of ESR and CRP are never raised. They ARE raised in 80% of PMR patients although they may not be very high. If ESR/CRP are raised - it isn't fibro. And fibro DOES NOT respond to pred - although you will find doctors who say it does. PMR should - although the 15mg dose often suggested my take a while to result in relief, 20mg would achieve it faster. 

    This paper suggests a way of using pred to see if it is likely to be PMR:

    http://www.rcpe.ac.uk/sites/default/files/quick.pdf

    The patient is given a week of vit C tablets, a week of pred and another week of vit C. I assume the idea is that the patient is taking a tablet the whole time so that might elicit a placebo response. Though you'd think someone would  notice the difference! In PMR the pain improves a lot over the week of pred - and returns over a similar time period when the pred is stopped. This perfectly safe and provides a good answer for the majority of patients. 

    She may be scared of pred - but longterm at PMR doses it is rather safer than daily ibuprofen! 

    • Posted

      Thank you so much for your quick response Eileen.  Your knowledge is so important to our existence. 
    • Posted

      Hi Eileen - I was very interested to read that bladder problems can be part of PMR - I didn't know that! When I first got the symptoms of PMR I also thought I had a bladder infection at the same time (which made life hell in the mornings, as you can imagine - struggling to get out of bed, but bursting for the loo!). When I started on pred the symptoms disappeared and I thought no more about it. 

      Interestingly, when I reduced my pred from 15mg to 12.5mg, I noticed the symptoms (needing to pee urgently) came back slightly but it seemed sort itself out after a few days. Is it coincidence or PMR?

       

    • Posted

      I told a renowned PMR research rheumatologist and she was surprised. When she started asking her PMR patients about it - yes, loads of them had bladder problems. 

      I think the reaction when you reduced was probably the PMR getting on top for a few days - patients often suffer steroid withdrawal.

  • Posted

    As it took 8 months for me to be diagnosed, I was living for 4 of those months on 14 Advil a day!~  I empathize!

    Have her go see a rheumatologist!  That was the only way I eventually found out what I had......and you don't want to know how many doctors I saw in the 8 months prior.

    It is an often misdiagnosed disease.  So many people who have been told they have Lyme Disease have PMR and don't even know it.  It for some reason has been increasingly happening,  The one young doctor I saw that he was surprised to see virtually every other question on his boards being about PMR, 

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