Pain in one area only?

Posted , 7 users are following.

Steroids, following blood tests, have improved my PMR- shoulders and neck no longer hurt. But if the weakness and pain do recur, it affects just one area only now (one leg/hip). Is this the experience of others- that just one area can become a problem again, leaving the others OK?

0 likes, 11 replies

11 Replies

  • Posted

    It sounds to me as if you may have either trochanteric bursitis - inflammation of the bursa over the surface of the hip bone - or myofascial pain syndrome which is affecting your lower back. The bursitis will be aggravated by walking or climbing steps, the lower back problem by various things including walking, bending and so on. The myofascial pain syndrome leads to trigger points of inflammatory substances forming knots in the muscle and they can cause referred pain into the hip and thigh. Both can be calmed down at higher doses of pred but can return as the dose is reduced. The best and quickest way to deal with both is local cortisone injections which really achieve good results. Myofascial pain syndrome can  be dealt with by a good physio who can mobilise the knotted muscle manually. 

    I've had both, both were treated with cortisone jabs here in Italy. A rheumatologist in the UK asked me just this weekend if I knew of many other doctors in the UK who would use this approach as it seemed the best way to her to approach such a problem and she is a PMR specialist. Here, GPs happily give such injections - I never asked my GP in the UK so I don't know if thatis an option or if you would have to be referred to the rheumy clinic.

    PMR pain proper tends to affect both sides - it may appear in one side first but the other side usually follows soon after.

  • Posted

    Hi Herb?

    I am on 30mg of Pred and still have some slight pain in my hips, both of them most of the time, but occassionally one. There is no regularity to this happening.

    I have had an MRI done on my hip area and everything appeared to be good.

    Maybe you need to try a slightly higher dose of Pred for a few days to see if it helps.

    Check with your Doc first, hopefully he is open to suggestions.

    Cheers

  • Posted

    Hi. Based on my personal experience, my answer would be yes! The pred seem to take away the pain in my chest, shoulders and lower abdomen but every morning the top of my right arm is very painful until about an hour after taking my dose. On exertion, I get terrible pain in my left hip. I go through this for about a week after each pred reduction then it's not so bad until the next time. The pain eases if I pace myself but I find this very difficult to do. I have this powerful urge to do all my 'chores' in one go, so that I won't feel guilty when I sit down! It really helps if you can manage it, so I am persevering. My physio is helping me with tips such as putting a sandwich box underneath the bowl when I wash up, to keep me more upright. (Simple but effective) Hope this is of some help. Good luck.
  • Posted

    For me, for a few months even when on 15mg pred I had bad hip pain, though the other pain (groins, arms, neck and ankles) were/are so much better on steroids. Ive not had that pain for ages.

    Thinking back however, I had that type of hip pain long before the PMR and I would say, after reading up on it when it was suggested to me, that I do and did have trochanteric bursitis. It is worth considering. I am amazd how many people have this who then go on to get PMR.

     

    • Posted

      I have medical colleagues who are a sure as I am that it can be linked - it is the same cytokines that cause the inflammation. In PMR they are "all over" and cause general pain and in the more localised sort they are concentrated in one place. The PMR dose of pred helps but isn't concentrated enough to relieve the inflammation quickly - I found the original bursitis faded after several months. The last lot was so severe when it returned that it needed concentrated local cortisone.
    • Posted

      nteresting Eileen. My hio used to be so painful, Id have to hoist my leg up in bed as the weight of my leg made things worse. It came in waves. I could go a month or so with not much pain and other times it would flare up. Id be interested to know more about cytokines. I will see if I can find info to read up on. I wonder when I cut down if it will be bad again. We shall see I suppose - could be a while as my withdrawal is so super slow.
    • Posted

      Sorry about the typos' I am guessing you'll know what I mean redface
  • Posted

    I have had that same experience with the pain in the right shoulder remaining after the othe pains have faded away.  I believe that once the stiffness gets in there, it may take a little extra effort to get it out. Also, the PMR might have exacerbated something that was already there, but somewhat dormant without the added problems of PMR.  For example, I have some arthritis of the AC joint which didn't bother me until the PMR started.  Consider going to physical therapy.
    • Posted

      If it is trochanteric bursitis physical therapy doesn't have much effect - movement makes it worse, icing and rest can achieve so much but when it gets beyond a certain point it is also no use. They used to use an ultasound therapy here in Italy but it has been shown to make little difference and isn't economic anyway so has been stopped. 

      IS your AC problem proven arthritis? I was told my joint pains were OA on the basis of examination, no scans - there is no evidence at all of OA and the hand and knee pain that was blamed on OA definitely wasn't.

  • Posted

    yes i had it in shoulders hips knees and bum bones, started pred 20 mg, now down to 6mg. i only have pain in bum bones  but it is tolerable just hopeing as i get lower on the pred it wont get  worse.  fingers crossed  but i will lower the pred more slowly.

    as mrs o and eiileen suggests

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