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Name that disorder!

Posted , 6 users are following.

gail2910-US-MI
gail2910-US-MI

I will try and be succinct. I am gathering your wisdom and help thinking my situation through before calling my rheumatologist. 

To recap, I originally wrote forum back in May following what I thot was a flare of PMR. At the recommendation of rheumy, I increased Pred. from 2 mg to 12 mg over 2 wks w/o any benefit. (I had been on Pred starting at 10 mg very successfully following initial dx in Nov. 2012) At that point, I asked to be seen in the office.

When I got in to see dr., he dx’ed me with Trochateric bursitis and tendonitis following overuse injury (run through airport). He gave me cortisone shot and five days on Indocin (NSAID) Blood work was normal. My improvement was pretty dramatic.

I have reduced back down to 5 mg. Pred and remain on 15 mg qd of Meloxicam. Pred is for PMR and Melixicam (Mobic) is for the tendonitis. They are not two drugs I want to take at the same time for very long and I do have some GI complaints. My dr. concurs but for now I need both.

So, my sx have worsened in the past two weeks or so. I was at the lake on vacation. The location of pain seems to be sometimes trochanter, always hip flexors, groins, occasionally glutes. I am functionally quite impaired, can't exercise, walk with out peculiar rolling gait, etc. You all know the story.  Sometimes I feel like my legs are full of sand (heavy and “logey”) I attribute this to Pred but it may be PMR.

My goal is to know for sure what we are treating. If it’s a PMR flare, I could up the Pred. If it is not, I’d like to stay at 5 or reduce and treat tendonitis more aggressively. I see three possible action steps. 1) get more blood work done 2) Try Indocin again for 5 days and see if we can knock out inflammation 3) weight bearing hip x ray to see if Osteo arthritis is involved much. I know I have some.  What am I missing? Does this make sense? 

As always, thank you for your help. All thots welcome. Gail

0 likes, 18 replies

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  • EileenH
    EileenH gail2910-US-MI

    Posted

    Needless to say I'm with lodger on this one - what you describe sounds similar at least to either piriformis syndrome or myofascial pain syndrome which cause similar problems - and also similar to some of the PMR problems. Sometimes they will improve at higher doses of pred only to reappear at lower doses. They DO improve with cortisone injections, usually many doctors won't give more than 3 in a year but it does often need more than one to clear out the inflammation. Piriformis can be helped with physio and exercises, myofascial syndrome isn't quite so amenable to physio. However - both can be helped dramatically with Bowen therapy.
    • gail2910-US-MI
      gail2910-US-MI EileenH

      Posted

      Thank you Eileen, as I said to lodger, I'm looking for Bowen person.  I know there are other muscles/body parts involved. Not clear which is the chicken and which is the egg but I am now walking in such a poor position mechanically due to pain that back is now involved. Working on exercises with my PT (piriformis stretches) and they help; it just doens't "hold."
    • EileenH
      EileenH gail2910-US-MI

      Posted

      Because it isn't just the piriformis that is affected - you can help it but the other muscles are dragging it back again so it becomes a vicious circle. Hope you do find a good Bowen person.
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