Muscle pain, REST or EXERCISE?

Jim

\"If you can stand the pain a workout will not harm you\".

Jim, that is so not the case with PMR.

I was told by a rheumatologist that if my diagnosis turned out to be rheumatoid arthritis then I should exercise but if it was PMR I should rest. I have personal experience of overdoing a long walk once where there were no seats when the pain worsened which resulted in a massive flair in both symptoms and blood test markers.

Also contrary to you finding a hot bath of no benefit, I have always experienced relief from a warm shower, maybe not lasting relief but relief nonetheless.

It has oft been mentioned that men can have an easier ride with PMR but we have only recently heard of one man who overdid the window cleaning and payed heavily for it afterwards!

I'm sorry it sounds as though I disagree with all you have said but it's so important for any new sufferers \"looking in\" to have the real facts.

I do wish you well on a continuing smooth recover.

MrsO

Hello Jim..... I too do not wish to dispute what you have said because we are all different BUT I agree with Mrs O and also my physio has been adamant about gentle exercise and certainly not when in pain and when pain does start to stop immediately and rest! Otherwise damage can be done :roll: :roll:

I am 'allowed' to do some gentle swimming three times a week ( haven't started this yet) and walk a little each day.... I do the walking but on bad days cannot even get to my local shops which are only a five min walk away :roll: I certainly listen to my body and don't push it it all.

Am learning the need to rest, something which is hard as I, like most of you, was very very active prior to PMR ....... I want to be free of this disease when my treatment is over so am listening to all the advice I am given and following it very carefully.

I hope you are not doing yourself any long term harm by pushing through the pain :roll: :roll: I would urge you to exercise more caution.

Hello

Im with Mrs O on this one

I have had PMR twice and have found that if I exercise too hard my muscles do suffer I was pretty fit before it all started so feel I can speak as a \" proper exerciser \" Horse Riding , Gym , Aerobics etc Also when my PMR was at its height there is no way I could have got out of a bath !! I remember having got as far as all fours and crying with pain trying to haul myself the rest of the way out !! Showers now and I find warmth does help

Steroids do damage your muscles , or cause wastage and I am at present on a bit of a rehabilitation campaign with going to an exercise class designed for people who have health issues and Nordic Walking When I did try and carry on with my normal exercise regime I was getting pulled muscles which I hadnt got pre PMR

I feel gentle exercise is great and any mobility is good as sitting in a chair constantly will not help but anything where you feel the pain I personally feel doesent help as I am now having recurring problems with a muscle I strained at the back of my knee well over 12months after it happened As you get older I have found the damage you do to your body doesent seem to want to repair

We had a friend who couldnt cope mentally with the diagnosis of Rhem Arth and worked and worked physically until he would collapse and he has done so much damage to his joints because of this

We are all different how we cope with things but along with Mrs O I find if I overdo it I really suffer

Best wishes

Mrs G

Hi Jim,

It must feel like all the ladies are \"ganging\" up on you...but I have to agree with them.

I had a lot of muscle wasting when I first started on the steroids and a friend who is a physio gave me some gentle excercises to do with light weights....but stressed that if it caused any pain, I was to stop and leave things as long as necessary to settle.

On good days, I get out for a decent walk and do some weights for my biceps.....but on the bad days I can barely lift a bag of groceries out of the car and a work-out would simply not be an option :cry:

Yes...I would dearly love to be able to do more as prior to PMR I played 18 holes of golf at least 3 times a week and walked several K's everyday, but as I had a couple of flares last year, I am now in \"Don't rock the boat\" mode :roll: :wink: .That said, we are all different, so if your work-outs help you its great....but just be careful and don't over-do things as it would be a shame to aggravate your PMR when you have got this far in your recovery.

Best wishes,

Pauline.

Jimplus3: So now I'll heave in here with a bit of science! :lol:

Although there is a lot of dispute as to the actual cause of PMR, it is known that it is very likely that PMR and GCA (giant cell arteritis) are related and if you have one, you may develop the other. GCA in its pure form is very rarely accompanied by the muscle stiffness experienced in PMR but if certain arteries are affected you do get claudication in other areas besides the areas supplied by the tempoal artery which is where everyone tends to think of GCA occurring. Claudication (from the Latin meaning limping) is used to describe the pain that is experienced in muscles when the blood supply is not enough for the amount of exercise being expected of them. It is usually found in patients with peripheral vascular disease (diseased blood vessels in the legs and sometimes arms, very common in smokers and diabetics) and got its name because it makes the sufferer limp after walking, eventually having to stop altogether until the pain in their calves subsides and they can resume their walk. The worse it is, the shorter the distance that can be walked, especially at speed or uphill. When it is really bad you may only be able to walk 100 yds or even less.

On the other hand, in PMR it is common for the biceps to be affected and repeated activity such as bicep curls or maintaining a position (such as holding a phone to your ear) becomes painful. Some patients find their thigh muscles are affected, making climbing stairs painful. That was how I presented - I suddenly started to get excruciating pain in my quadriceps when using the crosstrainer at the gym after a couple of minutes. At the time, stairs were difficult but it was not until the PMR got very bad that I crawled upstairs on hands and knees.

You are quite correct in your assertion that muscle strength per se is not affected in PMR - it is the accompanying pain that makes it difficult to grip things. There is also often a degree of tendonitis and bursitis (as in housemaid's knee or tennis elbow) and the pain from these inflamed tissues can also be excruciating. Sometimes the shoulder stiffness also incorporates a lot of shoulder joint pain leading to a misdiagnosis of rotator cuff damage or simply shoulder joint bursitis. If it is then treated with a cortisone injection (which is one of the treatment options) a diagnosis of PMR may be made because other painful muscles suddenly improve. Studies have shown there is a degree of bursitis in various joints in PMR, even if the patient is not actually complaining of that, but the cost of using the necessary diagnostic imaging (usually MRI) on everyone would be prohibitive. However - taking steroids DOES sometimes lead to muscle weakness and wasting. That's different.

It is very likely then that the muscle pain and stiffness in PMR is actually due to an inadequate blood flow in the capillaries (the smallest blood vessels that join the arteries and veins and look like the branches of a tree) and this means that not enough oxygen and nutrients gets to the muscle when it sends a message that it is working and needs extra supplies. This should lead to the blood vessels getting bigger so more blood flows into the area - but they are damaged and are unable to respond. Furthermore, the waste products are also not being removed and so there is a build up of lactate in the muscles and this isn't a good state of affairs. Athletes talk about the \"burn\" - and that's the same sort of pain that claudication leads to.

For years there have been gym instructors shouting to work through the burn, \"no pain, no gain\", encouraging clients to exercise to extreme levels of pain. It's rubbish and any instructor who still does it needs to go and do some reading and get up to date. Professional athletes do all sorts of things to aid the breakdown of the lactate after their marathon or whatever sport they do - including standing in a wheelie bin of ice wate

Well said Eileen, and as usual full of info',

no need to say any more.

Hope today is a good one for all looking in, Julia

Jimplus3

I am not going to repeat anything that has been said in all the posts. I am one of those active people, who ended up with a Blue Disabled Badge and an Attendance Allowance and I can assure you I was never a couch potato.

What I do suggest you do, is scroll down and find the thread on Vit D.

Read it and then decide whether you want to ask your GP for a specific Vit D test. Vit D deficiency can mimic pmr symptoms, which is why it is included in the tests for PMR (Guidelines under useful medical information on www.pmr-gca-northeast.org.uk).

Jimplus3, what you need to know and remember is that [b:144a0c315c]currently there is no known cause or cure for PMR and GCA.[/b:144a0c315c] Scotland had the first dedicated charity to seek cause and cure and also friendlier medication, then last year the rest of the UK gained a charity, with similar aims. Lots of people are working to try and set up local groups and help people and ensure that research is being undertaken. There are 800 'orphan' illnesses and these two are included.

Have a look at the Scotland Website and the National Charity website.

Come back and let us know how you get on. And Good Health in the future.

I think the exercise v rest question is a difficult one and I do have some sympathy with Jim's proposition. Having said that I also think that \"nothing too much\" is a good pprinciple.

I am not the only one on here who has remaked that she often feels better after quite vigorous effort than on Sundays spent lazily reading the papers.

Today I had to walk much further than I have attempted for months in order to get to my dentist. I was slow and it hurt but now seven hours later I feel no worse than if I had been dropped at the door. ( double yellow lines and no badge ).

But there are days when I just feel too low to make any effort. Should I push? I don't know. We are told that steroids do not cure PMR. But what does show it the door?.I don't know that, either.

And then, did we bring this illness on ourselves by being the sort of people which so many on here do seem to be, who all their lives have lived a thirty hour day, eight day week?. Maybe research will give us the answers one day but they won't be the same for everyone, of that I'm sure.

:sheep::sheep::sheep: :zzz: Good night everyone. BettyE

I haven't said DON'T do exercise - I've said you have to build up to it bit by bit and know what you can do. It's a bit like a steroid dose reduction: dropping from 15 to 10 overnight is probably asking for trouble, taking 2 months to get to the same place via 15/12.5 and 12.5/10 mixes of pills will work much better in that there will be less agony on the way and longterm success is much more likely.

It is extremely likely that graded increases in suitable exercise will prove to be an armament in the management of PMR - it is already known that it provides an excellent alternative to higher drug use in diabetes and some other metabolic diseases. However - the emphasis is on suitable as it is possible to fall into the trap of doing too much or the wrong things and make the underlying problem worse.

EileenH

Hello everyone Great information in here

I do a little exercise when I feel up to it and stop if I can't manage more

Hi all

All I know is that recently, since being on 2.5mg every day, I have been feeling slightly achey in my upper arms and legs in the morning. However, on the mornings after I've been to an aerobics class the night before, I haven't had any aches! How strange - most people feel stiff after that level of exercise (I really go for it! - I've never been one who can put up with other people doing something better than me!!). It's just a bit weird.

Beev

Hello everyone

Blood flow is somewhat restricted in us people suffering from PMR and/or GCA and I guess when we are at the more comfortable stages of being able to exercise more, then following such exercise the blood is pumping through more efficiently thus improving aches and stiffness. I certainly always feel more energised after my walks and after Tai Chi. :D