fibromyalgia or pmr

There are a lot of overlaps between fibromyalgia and PMR - when I first started researching what it was I had I got to one stage where it looked like it was one or the other. There is no great surprise that docotrs can't work out which is which sometimes, after all, both can deviate from the textbooks. There is one major and reliable difference: a moderate dose of prednisolone improves the PMR symptoms by about 70% within 24-48 hours or so. The pain returns in a similar time frame if the pred dose is stopped a week later. Pred does nothing for fibromyalgia pain.

It is, however, possibly to have both - one lady on this forum does but I'm afraid she is (I hope anyway) otherwise occupied this week with a new hip, that's providing the hospital didn't have to cancel the op!

https://patient.info/forums/discuss/pmr-gca-and-other-website-addresses-35316

If you follow the link above you will find the first post in the thread has a load of other links. The next to last is a paper by former members of the Bristol UK rheumatology group which is aimed at GPs to assist them in diagnosing and managing PMR. They use a pred sandwich to confirm their suspicions of PMR: one week vit C, one week 15mg pred, one week vit C. In PMR the symptoms improve dramatically with pred and return to the old level in a similar time frame during the second week of vit C. 

Take it to your GP and ask him to read it and consider the implications - especially if the removal of your pred dose results in the symptoms coming back as bad as they were before. Have you ever had your ESR or CRP levels checked? The Bristol paper includes them being raised as a criterion but approximately one fifth of PMR patients do NOT have raised values. Fibromyalgia is not inflammation so they don't increase there which can be confusing for PMR without high ESR.

However - frankly, if I am in constant pain from an (apparently) benign condition, I don't really care WHAT is causing it once they have ruled out the real nasties like cancer. If one single drug achieves a dramatic improvement I want to explore that more. I presume your GP is terrified of pred and its perceived side effects. There are 82+, no one gets them all, some people get none. For many there are ways of managing the side effects - you can even lose weight while taking pred if you go about it the right way: I had raised cholesterol, that has gone along with 38lbs of excess weight from pred. I have never developed diabetes and my bone density is unchanged to all intents and purposes - despite nearly 6 years of pred and I am not alone. They are not inevitable but most doctors seem to believe we all turn into Cushings patients (the result of excess steroid) and crumble into dust. Ordinary painkillers have side effects too, some as bad as pred, but they'll tell you to take ibuprofen (which can lead to stomach bleeding quite quickly if you are unlucky) or paracetamol (which can make your liver very unhappy within a couple of months) without a second thought.

Take the paper to your doctor and ask to discuss it sensibly. 

Liz, your GP should know that steroids do not work for Fibromyalgia so must have suspected PMR to put you on this medication, and if you have experienced at least a 70% relief in your pain in a very short time, then I can't see why she would want you to stop them and suffer a return of severe pain if it is definitely PMR.  What was your starting dose by the way?  Also, if this is PMR and you stop the steroids only to have to go back on them, it could be more difficult to achieve such pain relief second time around. 

My mother was diagnosed with fibromyalgia 20 years ago- I have been trying to get her to see a rheumatologist and be re-assessed since a lot has changed in 20 years of medical diagnosis. How old were you 10 years ago? Were you perhaps under age 50 so they didn't even look at PMR for you?