Flare up again with PMR or ? something else
Posted , 14 users are following.
Hi there
I've been on this forum for a while and always read the posts. Now I need some help and advice. I've been on the PMR journey for 6 1/2 years now , having experienced all the flares and yo -yo ing with my dosage. I thought I am fairly stable until now with this recurring pain on my LEFT shoulder, upper arm and neck. And there is this tingling / pins and needles sensation down my arms which happens periodically . The pain is constant, like jabbing , piercing sort of sensation. It will go away for a while when I move about and stretch, but it will come back. I have this now for the last 3/4 months. But it seems to get more severe this last 3/4 weeks. It gives me a better night sleep when I take -Co-codymol. The Ibuprofen or Paracetamol don't seem to have much pain relief. Using the DSNS method , i am presently taking 5mg.I had a flare up in April 2019 when I had to go up to 15 mgs, but gradually I managed to come back down to 5mgs.Now I don't know what to do,! Do you think this is a flare, or could it be something else? It is the throbbing pain on my upper arm , neck and shoulder and the tingling which made me doubtful of something else. Could I have a "nerve trap"?Shall i go up my Pred? if so, how much and for how long ?The pain is affecting my sleep ! All your experience and advice will be much appreciated, especially Eileen's .Hope you all have a good day.
0 likes, 9 replies
patricia43291 ling42044
Posted
Hi Ling,
I bet it is not a flare, seeing it is only on one side.That is just my unprofessional opinion. I wonder if it could be a nerve being crushed by a compression fracture. I know this sound crazy, especially if you never had a fall or other reason to think it could be a spine compression fracture, but, if you have been on pred for that many years, perhaps your bones have suffered. I was surprised when they told me, I had one. Now I think it is the reason my toes have been giving me trouble, or my hip pain, on just one side. Anyway, wait for Eileen, she will have good advice.
Carnut ling42044
Posted
Sounds like classic symptoms of a cervical problem. I would see my doctor and see if I could be referred for an MRI of the cervical spine.
Heron82 ling42044
Posted
Hello, sorry to hear you are in pain. I agree with the other respondents, having had similar symptoms in the past it does sound like shoulder impairment. I would see you doctor or a physio. I hope it gets better soon.
EileenH ling42044
Posted
If it were me I would suspect spasmed muscles in the upper back that are causing pressure on a nerve - bit like sciatica but a different nerve. You probably need imaging to rule out a cervical spine problem and perhaps a referral to a specialist physio who can work on the muscles to release the tension. But the imaging to be sure it isn't due to spinal/shoulder involvement.
bob03667 ling42044
Posted
When I was first diagnosed almost 2 years ago, I had significant pain in both shoulders and upper arms. The Physical Therapist who gave me the exercises I have now modified and do every morning in our hot tub, started each session by identifying pressure points - mostly on my shoulders - and pressed on them. Sometimes it would just about lift me off the table.
Now lying in bed in the morning, I self administer some of those same pressure points and am amazed at how that affects and often eliminates or at least reduces the pain.
This said, you might try some physical therapy but make sure it's someone with sports medicine background.
ling42044
Posted
Thank you All for your advice. I took note of what you said. I had a therapeutic back, shoulder and neck massage this morning, and I feel a lot better, the pain now is less severe. If it doesn't settle , I will book a GP appointment soon. Shall i continue to stay on my 5mgs of pred, or Not to go up at all ? After 6 1/2 years of PMR , i thought I would see the back of it , but... it is not to be yet ! Will update you what happens next. Thank you.
Anhaga ling42044
Posted
As it probably isn't PMR it's better if you can manage not to increase the pred. If after further investigation rules out some of the other possibilities, or if the symptoms become more like the PMR you remember, then it would be time to consider an increase. I would suggest if may not be a good idea to taper right now either. Wait until you have a better idea what's going on. I'm glad the massage was helpful, that in itself is a sign that it probably is more of a nerve involvement than PMR.
dan38655 ling42044
Posted
I have often had to up my pred dosage by 10-20% for a couple of days just to see if some symptom or another is responsive to the prednisone dosage level and so is perhaps the result of too low of a dose.
Sometimes just the couple of days of added pred lets me go back to my existing dose with the symptom having gone (at least for a while but sometimes for good).
The last time I did this, it was my thumb joint hurting, something that has always responded well to a temporary dosage boost. Most frequently it is my shoulder joints where a symtom flare might occur, but also for example certain other odd symptoms such as tenderness at the palms or the bottoms of my feet.
My dosage requirement has always fluctuated seasonally, so I will assume that this and perhaps other factors likely are also affecting other's dosage requirements at any given time.
Such short-term adjustments to one's pred dosage can be the only way to know (especially as periodic blood tests might be months or years apart).
ling42044
Posted
Hi Dan
thank you for your reply. I might consider upping my dosage by 20% for 2-3 days to see whether there are any improvement, and if not, I will see my GP for further review.