Need medical understandung of pmr

Posted , 12 users are following.

Hi all,

Hope you are well,

I am having a "hit by a truck" day, albeit it a small truck.

Severe pain in legs and arms feel like cement is attached to them.

I have done "good pacing" this week or so I thought.

I have read and researched this condtion and the dire effects of it, but I seem to have very little understanding of what does this illness do to my muscles??

What is attacking, which part, and why do I feel like this for no apparent reason.

I thought I was quite knowledgeable, but I don't understand this.

Please advise, when you can.

Julia

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  • Posted

    Hello Julia

    My understanding of PMR is that because of the high white cell count caused by PMR the major muscles are deprived of oxygen - hence the pain. Prednisolone at the right dose dampens down these excess white cells and thus kills all the pain.

    Regards

    Gill

    • Posted

      I think cytokines are connected to white blood cells (made by them?), but not the same thing.  Isn't it inflammation-causing cytokines running rampant which cause the pain?

       

    • Posted

      Instead of supporting us the white blood cells go AWOL and attack. This causes inflammation and the pred is exceedingly good at reducing this.  I did not have a high white cell count when diagnosed, just terrorist white blood cells and an awful lot of pain!
    • Posted

      Okay, so I'm reading that the white blood cells attack the lining of the joints.  So why didn't my joints hurt when I was at my worst with PMR?  Or now, for that matter.  That was something I took note of because I thought it was OA which was causing me pain and I wondered why it wasn't in my joints!question

    • Posted

      That is interesting as PMR does not affect the joints as such unlike RA, it affects the muscles, thus the name polymyalgia. 
    • Posted

      PMR can also involve synovitis and tendonitis - inflamed joint linings and tendons. That causes what feels like joint pain rather than muscle pain. Then hip and shoulder pain can be due to bursitis - trochanteric and iliopsoas in the case of the hips, not sure without looking for the shoulders. It doesn't HAVE to involve them though - everyone is different. MRI studies have confirmed it in the last few years.

      I don't think it is the white cells that do the attacking necessarily, don't know to be honest - but the neutrophils rise and that increases the total white cell count. Pred works via neutrophils so that may be the mechanism by which pred manages the PMR.

      PMR doesn't attack the muscles directly - it is fairly widely accepted that it is probably a vasculitis (though the jury is still swithering), inflamed blood vessels, and that affects the blood flow to the muscles as the lumen of the arteries is narrowed, like furred pipes stopping water flow!

    • Posted

      PS - I have wondered if there is some involvement of the mitochondria, the "powerhouses of the cells". If they are compromised thay can cause fatigue and weakness (very basic, they cause far more than that). A study in the NE of England at present is taking muscle biopsies from patients who are willing and doing mitochondrial studies on them. 

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