Husband diagnosed with Polymyalgia Rheumatic

It is a bit unusual for ESR &CRP not to be raised and 5mg is not the usual starting dose for polymyalga rheumatica (my starting dose was 20mg/day

Hi Jo, if your husband does have polymyalgia rheumatica 5mg of pred is much too low to start with to have much if any effect. Normally you start on 15-20mg and see if it works, usually the result is magical if you do have PMR. You then slowly decrease ensuring that you still suppress the pain. Blood tests normally taken are inflammation markers ESR and/or CRP. Around twenty per cent of people do not show a reaction for some unknown reason which can be a bit of a problem when trying to diagnose the problem

Five mgs of pred is unlikely to achieve a lot unless he is very lucky - the usual starting dose for PMR is at least 15mg/day which is a moderate dose, not high. So if the 5mg doesn't achieve anything - ask the doctor why they are using such a low dose. If they get stroppy or try to tell you it isn't PMR after all, do try to see a different doctor for a second opinion.

PMR usually lasts anything from 2 years up and the average length of time needing pred is just under 6 years. However, men often do much better than women - almost as if it is a different disorder in men than women. About 3 times as many women as men develop PMR.

Usually the doctor starts you at a dose that is higher than you are likely to need (20-25mg is the high end of the range) and then you taper the dose slowly to find the lowest dose that manages the symptoms. This varies from person to person - as does the time they need it for. One of the side effects of pred is increasing appetite and many people gain a fair bit of weight - one way to avoid that is to cut the amount of carbohydrate you eat. This also helps to reduce the risk of developing steroid-induced diabetes which is also possible.

One other thing to watch out for is headache, jaw and scalp pain and visual symptoms. PMR is related to another illness called giant cell arteritis and some people with PMR go on to develop it. It needs a higher dose of pred to manage it so if your husband develops any of those symptoms make him go back to the doctor immediately. If you can't get an immediate appointment then go to A&E/ER for medical attention because if it affects his vision there is a risk of sight loss. This isn't to scare you - but it is important to know.

If you have any specific questions do come back and ask them. What country are you in? Not being nosey but it helps to know when we give you advice or suggestions,

It does seem a low starting dose - is it relieving his pain?

If it is polymyalgia rheumtatica (PMR) it could go on for some time but the correct dose of prednisolone will help,.The 'correct' dose varies greatly from person to person. it is however much he needs to control his pain.

I was diagnosed earlier this year and currently on 10mgs pred and am practically pain free.  You will get lots of information on this site from people who are experienced and knowledgeable, I am just learning all about it myself.

Good luck and best wishes to you and you husband.

Kate

 

Well Jo, everyone seems in agreement if your husband has PMR, too low a does! I am a cyclists, came down with intestinal virus, down for a few days, next terrible pain and stiffness in the groin. My doctor tried me on 20 mg of Prednisone, it took about 2 weeks before I felt better. I wish him well. ☺️

As you all know this is a wonderful place to get information and answers. Thank you all very much for the input. Jo

 

I was started on a trial dose of 10mg of Prednisone because I represent the one I five patients that is Atypical in terms of blood work.  I had immediate relief and a month later I was raised to 15 mg. The rheumatologist said my “honeymoon period “ was over. I

In other words the Prednisone was used as a diagnostic tool.

Now I have reduced to 7mg...

when will this be over? I am tired of feeling flu like symptoms and not feeling like myself....