PMR in remission, want to excercise hard again can that cause a relapse?

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I am 59 years old, some what active. I came down with PMR around 2.5 years ago. Started at 20 mg.

prednisone to 0 mg. over 2 years. Slow taper was the key around .5 to 1mg. a month. I have continued to bike ride, or paddle surf 4 to 5 times a week. My energy level is around 70 percent before PMR. I would like to push my work outs harder but cant find much about the risk of relapse if I over due it. Not sure if that is even a issue after remission. The information is hard to find on the web, they have mostly the basics. If someone could direct me to more information I would appreciate it.

Thanks Woodrow

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  • Posted

    everyone is different but my experience is after 2&1/2 months off from prednisone at age 66 I slowly increased my exercise to pre PMR levels. I am a free style long distance swimmer. I had a painful flair primarily effecting my arms, shoulders, and hands. I increased my meds to 5 mg and stayed on that level for 9 months. I can exercise as I want. I have PMR and GCA. Started prednisone at age 64 at 50 mg. I had a high stress job and retired at age 67. I am now on ACTEMERA and again tapering prednisone, this time I am keeping exercise level at 3/4 level of previous level. will be tapered off prednisone by JANUARY. so far no flairs.

    • Posted

      Question to Eileen, our resident expert on PMR.

      How would you define a 'flair'? As we all try to come down gradually from whatever prednisone dose we're on, are there warning signs that a major flair is about to come on?

      I ask that because sometimes I will have more than the usual get up in the morning shoulder stiffness, which mostly goes away after I do my exercises and I'm wondering if it's the beginning of a more significant flair.

      But, how would you describe the difference between a minor flair and one that probably means you should up your prednisone dose for a while?

    • Posted

      All depends if you have the sense (not meant in a derogative way I assure you) to recognise that the current dose may not be enough. If it happens during a reduction step it should be fairly obvious. However, you can have a flare because the underlying diseases activity is increasing even though you are at a stable dose.

      It's part of the reason we bang on about small steps and not hurrying - staying at a new dose for a few weeks should let you identify if it is still enough. You shouldn't feel worse at the end of a reduction step than you did at the start.

      I don't think there is such a thing as a minor flare - if you start to flare because the current or new dose is not quite enough then over time the inflammation may well build up until you are back in the state you were originally, like a dripping tap fills up a bucket sooner or later.

      If it is only happening occasionally - have you tried keeping a diary of dose/symptoms? Overdoing it, change in diet, other things going on like stress, all can make PMR symptoms more obvious.

  • Posted

    Hi Woodrow. I was like you, an athlete who loved endurance sports, running, swimming and cycling to the point of pushing the limits all the way into my 60's. I had PMR twice. Dont know if it was the trigger as the first bout hit while training for a 100 mile charity ride. It turns out that severe aerobic exercise causes inflammation and that is not a friend of PMR, or for that matter your body as a whole. As an example I suggest you Google the relationship between cardiovascular blockage, inflammation and endurance athletes like marathoners and the counter-intuitive results will shock you as it did me. Turns out that moderation is the key to healthy, beneficial exercise. Your particular activities don't sound like they are too severe unless you push it to the point of exhaustion. Its hard to accept that our age requires us to throttle it back a little but don't risk inviting PMR for a return visit.

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