Posted , 6 users are following.
Hi Everyone,
My mum has just been diagnosed with PMR and has been put on 20mg of prednisolone. This is her 3rd day but there isnt much improvement at all in fact if anything she feels worse due to not taking the other painkillers she was on. I know its early but I have read that most people improve a lot after this time.
Thanks for any advice :-)
0 likes, 5 replies
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EileenH diane1705
Posted
There are quite a few things that can cause the symptoms of PMR and the doctor should have investigated many of them before deciding it was PMR. Some respond to pred, others don't. For what is regarded as strictly PMR the expectation is that there should be a 70% improvement in the symptoms within a few days to 15-20mg of pred. If this doesn't happen the idea it is PMR should be reconsidered. Late onset rheumatoid arthritis can appear very similar and doesn't respond much to pred. Vit D deficiency can also resemble PMR and should have been tested for.
It's Friday so I imagine she won't have access to a GP before Monday - if there isn't any improvement by then you should tell the GP you aren't accepting the diagnosis without further investigation. Ther is no real reason why she shouldn't take painkillers to get through until then unless it was NSAIDs (like ibuprofen) she was taking - paracetamol or codeine are fine.
If you go to the top of this page you will see a row of red print with > Polymyalgia and GCA at the end - click on that and it will bring up all the threads in this forum. At the top is a "pinned" post with links in it to other forums and sites which you may find useful. There is also a link to this paper:
"Our approach to the diagnosis and treatment of polymyalgia rheumatica and giant cell (temporal) arteritis" by Quick and Kirwan.
This is aimed at GPs and includes their "sandwich test" to sort out PMR from other possibilites - you give pred for a week, between a week of vit C on either side, the symptoms should improve dramatically with pred and return as dramatically when you stop the pred. Other things just don't do that and to be honest - it doesn't sound as if your mum is typical of PMR. Either the GP needs to do something or he needs to refer her to a specialist.
Good luck, and do let us know how you get on.
Eileen
MrsO-UK_Surrey diane1705
Posted
Sorry to hear that your Mum is still suffering in spite of being into her third day of steroid treatment. Although most people do experience a big improvement in their pain within a day or two of starting steroids, we do come across a few who say it took at least a week before they felt relief. So, as Eileen, has said, do go back to the GP next week if there is still no improvement by then and seek further investigation/tests especially if things like rheumatoid arthritis/Vit D deficiency haven't already been ruled out. Please give our best wishes to your Mum.
beatrice74480 diane1705
Posted
Light diane1705
Posted
I've noticed on this thread that some people start very high and then when things have evened out, slowly creep down.... slowly, very slowly is the way...
Best of luck!
EileenH Light
Posted