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PMR and Rotator Cuff Injury

Posted , 5 users are following.

bob73443
bob73443

Hi all,

I've had PMR for almost a year, diagnosed and treated with PRED now for about 3 months.  I'm on Eileen's slow reduction program, going from 15 to 12.5 mg.

Almost immediately after going on the PRED, I started having problems with one of my shoulders, not being able to lift it over my head without some pain.  These past few days, it has gotten rather severe.  I can't even reach out to a toll attendant on a highway to give them the toll.

Looking up the symptoms, it seems like this might be a rotator cuff issue.  So here's the question:

Can PRED make us more susceptable to tendon problems (embrittlement)?  I would have thought that the PRED would have helped any rotator cuff inflammations, but then I remembered that I severed my achilles tendon a few years ago after a podiatrist injected me with a shot of cortisone.  The surgeon said that the cortisone embittled the tendon.

Again, does anyone know of any linkage between prednisone usage and tendon embrittlement?

Thanks all,

0 likes, 6 replies

6 Replies

  • EileenH
    EileenH bob73443

    Posted

    I think it is mainly injections that are not good for tendons, in that they can result in rupture, but long term use of steroids probably does make tendons more susceptible to damage judging by other people's experiences.

    Having PMR, being on pred, doesn't make you immune to other problems though and what you describe sounds very like what my husband had last year - a tendonitis/rotator cuff problem. There are several causes, including impingement as well as tears and it may just have been coincidence that you noticed it when you went on the pred. After all, it may have been masked to some extent by the discomfort you had with the PMR so you didn't notice it as much until the pred eased the PMR symptoms.

  • pauline36422
    pauline36422 bob73443

    Posted

    yes i  tore a tendon on my upper arm  about 10 weeks back i felt it go when doing some twisting of my arm.   but  after putting up with it   for  7/8 weeks it wasnt realy getting better,  so i put my massager  onto it daily, and it did the  trick,   although it isnt fully recoverded  it is well on its way. i have been on pred 20 month  from 20mg

    now down to 2.

  • MrsO-UK_Surrey
    MrsO-UK_Surrey bob73443

    Posted

    Bob, there was an article about rotator cuff syndrome in one of PMRGCAuk's newsletters.  It talks about long term use of steroids being a cause of softening and weakening of the tendons and ligaments around the joints, particularly the shoulder.  Combining age with steroid use makes rotator cuff tears quite common.  It recommends increasing our level of physical activity gently as we are reducing our steroid dose, but not overdoing the exercise.  However, in the case of a rotator cuff tear, you need guidance as to how to first develop the range of motion of your arm without pain, and then to build up strength gradually using resistance exercises.  It is suggested that if your GP can't help with this, you should ask to be referred to a physio.

    Hope that helps.

    • doug36397
      doug36397 bob73443

      Posted

      Hi Bob,

      I find that PMR tends to find a joint and INFLAME it.  It jumps from one to the other but when your shoulder is involved it takes months to resolve...PT helps, I found that the injection didn't help much.  I do intensive rotator cuff exercises for years the pain/inflame is not an injury just the nature of the PMR.  The problem with shoulder is the pain with sleeping, sometime voltaran cream is helpful at night.

      Good Healing

       

    • EileenH
      EileenH doug36397

      Posted

      To be honest Doug, when I hear a patient say that I wonder if it is PMR they have. PMR is TYPICALLY bilateral and joint problems affect both sides, even if one is slightly worse than the other. PMR presents very similarly to a few other arthritises - that is part of the problem of identifying it. 

      One very common mis-diagnosis that is relatively often made is for LORA (late onset RA) and about 1 fifth of patients initially diagnosed as having PMR later have their dx revised to LORA. Very early RA can often start in the form of an inflammatory arthritis in individual joints which moves around the body unpredictably. If there is a 70% improvement in symptoms in 24-48 hours with a moderate dose of pred it is a fair indication it is PMR but if it isn't that clear then further investigation is needed.

      Yes, PMR can involve shoulders - but if it is only one and doesn't improve with oral pred then it could be either another arthritis or an injury and needs proper investigation.

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