Muscle weakness in arms and shoulders

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784879/

thanks Anhaga I'd appreciate that very much.

Anhaga,

I'm interested in reading the article as well.

Cindy

The link is to a website which is usually approved, so let's wait for the moderator to decide.  

Is it the medscape article?

Corticosteroid-Induced Myopathy Treatment & Management

as that was the only one that came up on the first sweep!!!!

I'm very happy to read this: "Weakness is primarily proximal; pelvic girdle muscles are more severely involved than arms; and cranial nerve innervated muscles and sphincters are spared." lololol

Quite  

My doctor said last week I had steroid myopathy just as I sat down, thought how on earth could she know that through my trousers!...

​Because of being in so much pain with lower back/hips/legs, she wants me to have MRI scan.....could the scan show anything concerning PMR  other than  myopathy?  Thank you

Yes, I remember you saying - x-ray eyes obviously!!! And you aren't allowed to be on pred and slim!

She may want to see if there are any spinal problems such as spinal stenosis or other signs of arthritis. But in my experience most low back and hip pain is soft tissue: spasmed muscles and bursitis. Muscle problems don't show up on MRI - it will visualise the trochanteric bursa - and show if it is enlarged, don't know if it shows up inflammation though.

Perhaps it was the way you walked in and sat down?  

Eileen my acupuncturist feels that since PMR is an immune disorder treatments such as laser therapy and physiotherapy are not that effective.  Have you personally had benefit from physio or read of others here with steroid myopathy benefitting from such treatments?  I know that this upper arm shoulder weakness started slowly 6 months ago and I had x-rays which showed the shoulders were fine but there was some mention of tendons in the upper arms possibly being inflamed, or at least that's would I think was implied.

I have serious problems with trochanteric bursitis (in the hips) to the point I'm about to get a cortisone injections under ultrasound in the attempt to relieve me of the pain and allow me to walk properly (and maybe even exersice!). So that's something that might show up under MRI?

I did wonder that, but you would have thought she would examine me first with my problems, and then comment.....

 Thank you for that, when get MRI results, will post on here.. 

The acupuncturist is probably looking at the wrong aspects of physio. The physio is to teach you the right sort of exercises that will reduce the effect of the myopathy and it DOES help. If there was mention of tendon problems has that not been investigated?

Flip - I had mine without u/s - simple technique: palpate the area until the patient squeals loudest. That is the most inflamed site - steroid injection there! It worked very well! It doesn't need a JOINT injection so they don't bother with u/s. I'd have to stop taking anticoagulants for days as well so I am very grateful!

Leonard:

It just so happens I have just found this post on another forum so have copied it for you:

"I was diagnosed in January with steroid myopathy, and was taking 7.5mg at the time. In March I had to go up to 10mgs and started getting severe pains in my thighs, it is a burning pain which builds up until I can no longer stand it, and have to sit down. When I mentioned it to my Rheumy she said it was the myopathy causing that pain and not the PMR.

I am lucky that the hospital I work for provide an Occupational Health physio, who I have been seeing since Feb. He is terrific and adjusts my exercises each time to accommodate what the problem is on each visit. As mine affects my quads I found doing exercises such as straight leg raises and squats very helpful. However, just the smallest increase in steroids can undo my hard work. I now have a routine of doing these exercises daily, and find this makes things manageable. You are right about it won't resolve till your off steroids, although it does improve as you lower the dose. Although you feel the higher dose let's you get around more, you risk your leg muscles being so weak, that you will replace one pain with another unfortunately. I now need a stick when walking for long periods, or when walking even the slightest incline."

I should add that this nurse is under one of the top PMR research rheumies in the UK - who I would choose as my doctor if I were in the UK and it were ethically appropriate since I work with her group.

Hi EileenH , good info: I know what a squat is,but what is a straight leg raises ?  I get very bad lower back pain,hard to stand and walk some days, more on the right side than left: So happy to do some excercise now reducing : 40mg to 32.5.  Cheers

I think it is done like this: yo lie on your back and raise one leg at a time with the knee straight:

The starting point is lying on the back with both legs out straight.

One leg is then lifted a few inches off the couch/floor, keeping the knee straight.

The position may be held for 2-5 seconds, before the leg is lowered slowly back to the floor.

If you google straight leg raise exercise you will get links to a load of articles (that above is from one) and even videos showing how and what it does (strengthens the hip flexors, muscles around the top of your thigh and around your hip).

Go slowly at first - just a few reps at a time and increase just one or two at a time. It is very easy to overdo it at first.

Thanks , makes sense : I'll youtube :

I have chronic back pain and have worked with a physical therapist a lot. Do not do the straight leg lifts. You could potential injure your back further. It is important to strengthen your core but not this way. I suggest that you see a physical therapist a few times at least to get some exercises do at home. You don't necessarily have to go a lot of times period just 2 or 3 times to get some exercise and some paper is enough. Then you'll have some working knowledge of proper exercises for someone with a bad back

Exactly.  I have several exercises I've done for years to strengthen core and none of them involve straight leg raises.  One is lying on back with knees bent.  Tighten muscles (Kegel exercise), raise and lower the legs (keeping them bent) one at a time, until done 60 times, that is 30 times with each leg.  Repeat entire exercise three times.  Another is to be on all fours, pull stomach towards spine, and lift opposing leg and arm, sixty times, 30 each side.  I have a couple of other exercises to maintain mobility of the spine.   More recently I've had to add several others to combat incipient kyphosis and mild scoliosis.  I do these exersices morning and evening.  I tell ya, this health stuff is a full time job!

My GP was going to do the injections in the surgery, but decided that it would be best to really hit the worst spots. TBH, I'll do just about anything to get me moving again - I miss running! (never thought I'd say that in my lifetime!)

I suggested links - which show the correct way to do the exercise. And they are the same as a Pilates exercise I did - lying on your back, one leg bent, lifting the other leg straight.

I was only describing the physio exercise I was prescribed specifically to strengthen core.  Did not mean to suggest there were no other safe exercises.  

Darn - it was meant to be a response to amkoffee - not you!

I had the same thing about 90 days before I was dx with PMR.  I got 100 mg. medrol injection into my hip with great relief.  80mg. is probably the usual dose.  I had one more injection 3 months later with great relief.  Try it, it's very helpful!      Elinor