1. Community
  2. Bones, joints and muscles
  3. Polymyalgia Rheumatica and GCA

Pain

Posted , 4 users are following.

judy47
judy47

I was diagnosed with PMR three years ago.  Took prednisone three different times and it helped each time.  Haven't been on prednisone for several months.  Now I am having pain in my lower rib cage and both shoulder blades.  Have any of you with PMR  experienced  this type of pain? 

0 likes, 8 replies

8 Replies

  • MrsO-UK_Surrey
    MrsO-UK_Surrey judy47

    Posted

    Judy, yes I had a bout of pain in my rib cage area during my days with PMR and at the time I remember being in touch with another lady who complained of similar pain.  I also suffered pain in the shoulder blade area whilst on the very low doses of steroid which was sorted out by a few sessions with a physio using gentle massage and heat treatment.  The physio found several knots, probably due to steroid weakened muscles.  If you have the shoulder blades on each side affected, that does sound very PMR-ish, unless of course you can pinpoint having done something that may have caused an injury?
  • tina-uk_cwall
    tina-uk_cwall judy47

    Posted

    Hello judy, I'm sorry to hear you're feeling not too clever. I was diagnosed with PMR this time last year although i began experiencing symptoms way back in the September, but because I had such a rubbish gp at the time who said she couldn't think what was wrong with me my trip to a rheumatologist was delayed because I had to request an appointment. Anyway, that's by the by. When I first had systems they were classic symptoms, eg, pain and stiffness started in the neck, migrated to my shoulders, hips and knees. However, by the time I was due for my rheumatologist appointment I had also developed pain in both my thumbs and like you are now explaining around my entire rib cage front and back, and if I touched my rib cage the pain was unbearable. I also developed a terrible pain just under my left breast, just left of my sternum. When I was prescribed preds all this pain went away but tHe  one pain that lingered was the pain just to the left of sternum. I had also had a gastroscope around the same time and the result was " a bit of acid injury where the stomach joins the oesophagus. Biopsies came back benign, (cardio-oesophageal junction, Ill defined abnormality, mild modularity GOJ probably inflammatory).

    My gp also then  prescribed omeprazole as she believed the pain just to the left of my sternum, under my left breast could be because of the sore and all these medications were probably antagonising it, although as I said I had the pain before I was diagnosed with PMR, but then the original terrible pain was not helped with all the pain killers I was taking. Since then all my pain had settled down but following my last reduction that didn't work the pain in my rib cage and left of my sternum have returned with vengeance. I attempted to reduce from 9 mgs to 8 mgs only to have to return up to 9 mgs after 16 days because all the classic symptoms returned. I remained in the 9 mgs for 18 days and then attempted to reduce by .5, ie, 9 mgs 1 day followed by 8 mgs the next. All appeared well then all of a sudden pains returned and this time all the pains in my rib cage and to the left of my sternum returned too.  I went back up to 10 mgs today in an attempt to control this flare up, there is presently no difference but I'm hoping to see an improvement within the next couple of days.

    today I have been very down as all the tapering I achieved over the last 3 months has been wasted and I'm now back to where I was in sep of this year. I will stay on 10 mgs for at least 6 weeks no matter what. But yes like you the pain around my rib cage and left of my sternum where unbearable. Christina.

  • EileenH
    EileenH judy47

    Posted

    Yes I have - but it wasn't simple PMR pain but due to myofascial pain syndrome (MPS) where spasmed muscles alongside my spine were pinching nerves causing referred pain into my ribs and shoulder blades - in the shoulder blades it was a tingling sensation, worst when I was sitting without leaning against the back of a chair. MPS often occurs alongside PMR but it can also occur on its own.
    • EileenH
      EileenH

      Posted

      Having read the other replies now - Christina, do consider you problem may be PMS. There is evidence that "flares" that appear at lower doses of pred are not necessarily the PMR but MPS that has been masked by the higher doses of pred as it is due to the same inflammatory substances as PMR - just they are concentrated in small areas rather than generally.
    • tina-uk_cwall
      tina-uk_cwall EileenH

      Posted

      Hello Eileen, I've never heard of MPS before, other than mentions of it on this site. I've just looked it up with interest. Are you saying that when I was suffering from all the PMR pain, some of that pain was then referred to my rib cage area, then when I was diagnosed and taking the preds, because the  inflammation was under control, there was no pain left to be referred. And now that I've had this flare up the pain surrounding my rib cage has returned because the inflamation and pain associated with PMR has returned?

      although I'm not sure if this is the case, it could very well be the answer as to the pain I experience when I touch my ribs, as historically although when I was suffering extreme pain from the PMRwhen I actually touched the area of the pain, that did not result in additional pain from the physical touch whereas when my ribs hurt, it is the opposite way round. I actually do not feel any pain until I actually touch my rib cage.

      a further 2 questions for you Eileen, why is it when my PMR pain returns through this flare up does my stomach sore become painful (please see my stomach diagnosis in my thread above)

      and, have you read any medical journals etc, that indicate that if the original PMR symptoms are left for a long time untreated, the flare gets worse over time, and that it will once treatment begins take longer to get under control, as there's more inflammation to die down?

      any ideas? But this is my second day at the uped dosage of 10 mgs and I'm definitely feeling a lot better than I did on Sunday so I'm now off to the hairdressers for some big time pampering. Christina 

    • EileenH
      EileenH tina-uk_cwall

      Posted

      The stomach problem - really don't know. Although the pred will also soothe the inflammation causing the gastric problem. Have you ever noticed: is the recurrence of either/both associated with a dietary change, even temporary? A trip out and overdoing it on sugar or other carbs for example? Being in pain can also affect such a stomach problem - when I broke my leg and mentioned stomach pain after a few days the consultant was furious I hadn't been given antacid medication to avoid that. Injury like that can lead to excess acid production in response and gastric pain.

      I haven't read anyting about delayed diagnosis making it more difficult to control the inflammation, no. But what I can say is that I had had PMR for over 5 years before being given my first dose of pred - and it worked in 6 hours. I was allowed a rapid taper over 6 weeks, 2 weeks each of 15, 10 and 5mg. Within 30 hours of the last tablet I was in bed in worse pain that at the start - although it is possible it just felt like that after 6 weeks pretty much pain-free. That first time I was still great at 10mg, OK at 5mg but after it all flared up again I never got things as well under control as that first time, needing 10mg. Three years ago I was switched to a different corticosteroid as prednisolone is not available here, just methyl prednisolone (Medrol). For some reason that didn't work well for me - and I had to increase the dose to get the same effect. In the end I was on 20mg and in a lot of pain. I had a bad episode of MPS as well so it is difficult to know which pain was which but I was terribly stiff. I had cortisone injections etc and then, on being switched to another form of prednisone I immediately was able to reduce - very very slowly but steadily and for the first time in 4 years got below 10mg. The MPS was still there - but since that has been fully sorted out, finally by removing a tooth afffecting my bite, I've got to 4mg. It IS known that if you allow too many flares it can be more difficult to get subsequent flares under control - more so than if it is a long time before the illness is diagnosed or treated.

      There are multiple possible causes of this pain and they become merged and muddied. A good dentist will check your bite - you will be asked to bite onto a piece of paper that leaves marks on your opposing teeth. Any teeth standing proud of the others can cause trouble - far more than you would dream, believe me! 

      Over time you adopt a posture that hurts least  - possibly one leg is shorter than the other, possibly your pelvis isn't straight, all sorts of things. Eventually your body just rebells and can't cope any more. A good physio or osteopath can check that and often do something about it.

      However - for the moment, stick at 10mg if that is enough to make you feel well. It was well over 4 years before I managed to get to below 10mg and remain reasonably pain-free. If the underlying autoimmune problem is active you need enough pred. I don't have diabetes, high cholesterol, have lost 17kg since the Medrol was stopped, no osteoporosis. Being at 10mg isn't necessarily half as bad as they'd have you believe.

    • tina-uk_cwall
      tina-uk_cwall EileenH

      Posted

      Thanks Eileen for taking the time to answer my queries. Now I know that having too many flares makes subsequent flares harder to control is interesting, therefore I know I'm right to stay on 10 mgs for at least a month, if not longer as I don't want to experience too many of them. Also that point is interesting as I had very comfortably reached 9 mgs and it was only following the reduction from that to 8 mgs that has caused 2 mini flares that has now seen me go back up to 10 mgs to hopely stamp its authority on the present flares. So really I'm worse off now than I was 3 months ago. I'm hopefully seeing my gp on Thursday just to advise her on my present status and I'll mention to her the flare up, if I can call it that of my stomach.

      thanks for all your help. Christina 

    • EileenH
      EileenH tina-uk_cwall

      Posted

      "So really I'm worse off now than I was 3 months ago"

      That is what tends to happen whenever a reduction is forced.

      On another forum recently a doctor who used to tell patients they MUST reduce their pred dose now has PMR herself. Now she understands what we face. And is asking whether there is so very much advantage in forcing your patient to go to 8 rather than 9mg if that then puts them at risk of a flare. 

      My point exactly. 

Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.