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Instant relapse on constant dose; local treatment for pain.

Posted , 10 users are following.

snapperblue
snapperblue

My symptoms started in mid-December.  I went on 15 mg prednisone on Dec 31 but had only very slight improvement, then to 20 mg on Jan 5 (a week ago).  After great improvement for 4 or 5 days (nearly painfree), the sharp pain came back in the arms yesterday (worse today) and hips are starting to hurt again.  Alas!  Any comment?

Also, when the pain is localized (like 2 x 3 inch area of arm), do muscle rubs or icing help reduce the inflamation?

This is a great forum!  Thanks all for sharing your experience and knowledge.

1 like, 24 replies

24 Replies

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  • lodgerUK_NE
    lodgerUK_NE snapperblue

    Posted

    Just a thought, did they test you for Vit D deficiency before diagnosing PMR?

    If not ask for it to be done, Vit D def causes aches and pains exactly like PMR and should be done and if deficient corrected with high doses of Vit D (Dekristol).

    • snapperblue
      snapperblue lodgerUK_NE

      Posted

      I was tested for Vit D last year and was OK.  I take 1000 IU of D-3 anyhow, since winters are gloomy here (northeastern US).  Thanks for the suggestion!
    • gpgp
      gpgp snapperblue

      Posted

      I have never read anything about NSAID gels being harmful in PMR. My father uses diclofenac gel fairly regularly and he has had PMR for 3 years
    • EileenH
      EileenH gpgp

      Posted

      Using NSAIDs and pred together longterm is not advised - both can cause gastric irritation and together the risk is higher. The fact the NSAID is topical makes not much difference. This is an extract from the NIH warning:

      "NSAIDs such as topical diclofenac (Pennsaid, Voltaren) may cause swelling, ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who use NSAIDs for a long time, are older in age, have poor health, smoke, or drink alcohol while using topical diclofenac. Tell your doctor if you have any of these risk factors and if you have or have ever had ulcersor bleeding in your stomach or intestines, or other bleeding disorders. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn); or oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone). If you experience any of the following symptoms, stop using topical diclofenac and call your doctor: stomach pain, heartburn, vomiting a substance that is bloody or looks like coffee grounds, blood in the stool,or black and tarry stools."

      The topical forms are absorbed via the skin - they wouldn't work otherwise - and so get into the bloodstream. Although the highest risk is the direct irritation of the gastric mucosa, many experts are also of the opinion that it is actually the presence in the bloodstream that is the risk factor. I know lodger above was warned not to use NSAID gels by her pharmacist. They never made any real difference for me in the years pre-pred anyway so I don't use them.

  • teenyjeeny
    teenyjeeny snapperblue

    Posted

    I do use cream as well as my steroids I have tried different ones and the only one that works for me is a cream from USa called Thera Gesic  get it from amazon.

     

  • dianthusdoris
    dianthusdoris snapperblue

    Posted

    Hello.  I too have only recently been diagnosed, and therefore coming upon this site and reading yours and the other comments has been very helpful.   For several months my very painful hips, neck and shoulder have been put down to arthritis, as I already have had this in knees and feet for several years.  However, the pain and stiffness was getting so bad that I drew sketch diagrams of my body and marked clearly in red where all the pain was and showed these to my GP.   He straight away suspected PMR and requested blood tests, but these were not very conclusive.   However, on 07.01.15. he started me on 15mg Predisolone, and led me to believe that I should be feeling wonderful in a few days!   After 4 days, I must admit I did feel a lot better but one week later, 14.01.15., my pain is back with a vengeance.    It is most encouraging to read that the commencing dose of 15mg  is not strong enough for some people - so I shall report back to my GP, and see if he will increase it.    Many thanks.
    • tina-uk_cwall
      tina-uk_cwall dianthusdoris

      Posted

      Hello dianthusdoris, welcome to the site although I'm sorry to hear you have been diagnosed with PMR. Normally the rapid response to preds, usually within 4 hours with a very very good responce within 4 days is how most drs confirm their diagnosis of PMR. And 15 mgs is very often the starting dose, however the dose can be 20 of even 25 mgs as of course all our bodies are different.

      i would definitely go back to your Dr for either an increase of they may want to do other tests to see if you have a different condition.

      your idea of the diagram is brilliant. Regards christina

    • EileenH
      EileenH dianthusdoris

      Posted

      You should demonstrate a significant improvement in symptoms within a week - but you may need a bit more. Or, as I ask everyone who says this: did you go and try to catch up with what you couldn't manage before as soon as you felt a bit better? Because if you did that - DON'T!!! You also have to help manage the illness by resting and adapting and pacing yourself. Your muscles have become intolerant of acute exercise - indulge them a bit.
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