Have I Got This

Sounds very much like PMR. Virtually everyone on this forum can identify with your symptoms.

One quewtion: is it sharp pain or a deep ache?

The general symptoms of fibro and PMR can be very similar - after I had had it for 5 years I did a lot of research to work out what it was I had, given it seemed beyond my GP! It really did come down to PMR with a slight chance of fibro since some of the trigger points are in similar places. I was referred - because I DIDN'T have raised ESR and CRP. The rheumy I eventually saw didn't agree it could be PMR - he wanted it to be anything but! But all his suspicions were ruled out one by one. I was about to head off to the US with my husband and so the rheumy gave me 6 weeks of pred (2 weeks each of 15/10/5) to tide me over until I saw him again. Less than 6 hours after taking the first 15mg I walked downstairs normally and back up carrying a cup of tea - something I hadn't done for about 5 years! I stomped down like a toddler and crawled back up on hands and knees.

He still didn't want to know and was insistent it was psoriatric arthritis so wanted to give me a DMARD, one where you have to avoid the sun and have monthly liver blood tests. I was about to move to Italy so that wasn't possible until I had a doctor here so I never saw him again - I wouldn't have anyway, I don't like doctors who don't listen to their patients, I'd had 2 that year which had caused a lot of unecessary trouble for me. A different GP listened - was convinced it was PMR and provided the required prescription. The doctors here are also convinced enough it is PMR.

There are 2 primary differences between fibro and PMR: one is that fibro almost never comes with raised ESR and CRP and certainly not because of the fibro, it isn't due to inflammation - I'm speechless a rheumy doesn't know that. PMR doesn't always come with raised markers - but 80% of patients do have them.

The second difference is that PMR usually responds well to a moderate dose of pred - 15-20mg/day is usual - which relieves the inflammation. Fibro doesn't - because it isn't inflammation.

This our collected link post:

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

where you will find loads of links you may find helpful. The NE of England PMRGCAUK site is particularly good. The other one I'd particularly mention for you is the "Bristol paper". It is to help GPs diagnose and manage PMR better - so your GP shouldn't be offended in any way(though everything is possible!). I would take it and point out their "test" of using pred for a week to see what happens - it is disputed by some rheumies but it does provide useful information.

If a large proportion of your pain and stiffness is relieved with pred it is most likely NOT fibro - it COULD be another arthritis but PMR is pretty likely and a good place to start. But as I say, I'm appalled your rheumy ignored signs of systemic inflammation. What planet is he on?

Where are you? 

I think there is a strong chance you have PMR

It does sound very much like PMR. However you mentioned that it is hard to lose weight. That could be a sign of

hypothyroidism which also causes body aches. I suggest you ask your GP to check your thyroid too.

I do hope your GP hears, reads and inwardly digests as they say.

My PMR was first diagnosed as OA but after blood tests which did, in my case, show very high ESR and CRP I was given 15 mgs. Prednisolone and, like Eileen, was relieved of almost all pain within 4 hours which my GP said was good enough for him. 

I was lucky. It was only three days from my first appointment to diagnosis.

Another possibility is elevated insulin level, which is quite common, is strongly associated with inflammatory conditions, and causes the body to quickly put nutrients into storage in the liver, muscle and fat cells, leaving the patient hungry even as they tend to gain weight.

I am able to reduce, by half, my current prednisone dosage through accelerated fasting (by riding a couple of hours on a bike), suggesting to me that this metabolic link to my pmr may be related directly to insulin level. It took me a few years of seasonally-varying response to the prednisone before I was able to conclude that there was a connection between my pmr symptoms and my "ratio" of diet to exercise. And, surprisingly, the large difference my response to the medication has consistently ocurred within a narrow range of body weight of just a few pounds.

So I encourage all pmr sufferers to experiment with this diet/exercise effect, perhaps setting a target weight loss of just a few pounds, to see what the immediate response is. I now regret previously dismissing this possibility, even as I suspected it early on, because my weight had dropped already due to pmr before I received a proper diagnosis. But with my seasonal activities having consistently led to a reduced pred dosage requirement, I now have the precious knowledge with which to control how much pred that I can get by with, and plan not to need any more seasonal dosage increases.

Hi Lindsey , I have both Fibro and Pmr and yes it's very similar

I found that prednisone doesn't help with Fibro and it's hard sometimes to know the difference.