PMR, Pred and Accidents
Posted , 13 users are following.
HI, I've recently posted about a broken collarbone, but have been thinking is there anything about Prednisolone or PMR that makes one accident prone? Just that since i dropped to 5mg, I've run into a glass door, causing concussion and a black eye and injured knee, then i fell off my bike fracturing the collarbone and cracking ribs, as well as injuring my good hip. I also got bit by a dog but more the fault of the dog? I'm pretty depressed and in a lot of pain at the moment. I also get stiffness in my other joints and jaw too from PMR, although it does'nt seem so bad compared with the trauma injuries to be honest so i'm tapring down. I'm still at work, but i get very anxious as well ad paranoid as imagine people are laughing at me - i'm safety officer you see. I feel terrible just now as i'm usually very active but cannot exercise at all now .
0 likes, 11 replies
sharlane76878 TonChe
Posted
janet06653 TonChe
Posted
Dear TonChe
A stiff jaw is a classic sign of GCA.
You may be more accident prone from the
PMR. I cracked my ribs when I was on a high dose of PRED . It can weaken bone strength. You may need to be very careful of your activities while on it.
TonChe janet06653
Posted
Thanks for your reply. I was on 5mg at the time which i believe can still weaken bones, and i wasnt going very fast at the time. Possibly linked to the knee injury as i don't cycle much in winter these days and was only on my bike to get exercise because of my knee prevented running. Can't do much now !
Elijo TonChe
Posted
Yes, I feel PMR did a number one me. I had PMR 2 1/2 years. Then fell & broke 3 pelvic bones. Rehab for a month, I gave up my bicycle. This year I have a-fib. They tried to put a Watchman device without success, ICU 5 days, hospital 10 days, home care for a month, balance problems and I really feel as if I have deteriated. I personally feel the PMR was the start of my physical problems I had always been very healthy. Doctors may not agree, but I'm the one w ho lives it! Hang in there, things should improve. Good luck!
TonChe Elijo
Posted
Yes i do feel for you especially the fib problem. Best stay positive and i'm sure you will be back to great health when you get it stabilised and PMR goes into remission. I'm keeping positive by planning my next marathon in Moscow in November.
EileenH TonChe
Posted
Many people with PMR report increased clumsiness, particularly in the early days or when flaring/inadequately managed on pred. Many mention difficulties in judging distances - so catching themselves on a door handle, dropping a glass as they put it down, tripping because the ground wasn't there when they expected. I noticed I disliked overtaking lorries on a relatively narrow motorway because I wasn't happy about the width available.
Others find that pred makes them unable to concentrate well - and that leads to minor accidents in the house.
But what you are saying really sounds as if you have reduced the pred dose too far and you are flaring. Which is also extremely likely as a result of your falls or the dog bite. An Italian study has found that a fall is enough to cause a flare in the activity of PMR - so post-trauma of any sort there certainly shouldn't be a reduction of dose for any reason and possibly even an increase:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5746636/
There are good reasons why the "old hands" on the forums go on ad nauseum about reducing slowly and in small steps AND about being careful about activity. There is a new normal - acceptance of that fact makes living with PMR a lot more comfortable. It isn't giving in - it is called realism.
TonChe EileenH
Posted
Thanks, but i'm pretty sure now i don't have a flare - my PMR symptoms are now slight and less after the accident/s. I've since reduced to 2mg with no increase in PMR stiffness or fatigue, but my knee is still very painful and fear i may have a torn meniscus. I'm convinced my broken bones and cartilage problems have been caused by Prednisolone - especially when i was on higher doses in the summer. I therefore hope to get to 1mg by next month or so to allow healing. Funny that i've never had any knee problems for 35years, then suddenly started with left knee pain 4-5 months after starting Pred even before the accidents and despite being lighter and fitter. I've also had harder falls off my bike before and never fractured any bones. Pred was useful when i 1st went on it, but it has certainly out lived its usefulness now so its time to say goodbye to it asap.
EileenH TonChe
Posted
Hope it works for you - but correlation is not causation so don't be too quick to blame pred!
TonChe EileenH
Posted
Thanks i do too. Just wondered if its allowed to taper completely off Pred before one goes into remission? I've noticed that i have a constant low level of stiffness/pain that is not altered whatsover by reductions or increases in Pred. I dropped 3mg in space of 3 weeks and did'nt even notice it! Now on 2mg and no change 2 weeks later. If it doesnt have any effect on me now, might as well stop taking it altogether?
EileenH TonChe
Posted
If you taper off pred entirely before the autoimmune process that causes the symptoms has gone into remission then sooner or later you will get back to where you were at the start. Most people have a low level of pain and stiffness from other things and the skill is to identify what is pred-responsive so most likely related to PMR and what isn't.
But whatever you do, please don't drop from 2mg to zero too quickly. Even a few months at 5mg pred is enough to suppress the function of the HPA axis (hypothalamus, pituitary, adrenal axis) and it is reckoned your body requires about a month for each month of suppression to recover fully up to about 9 to 12 months for people who were on pred for more than a year or so. Everyone is different. That includes some people being able to function well on 2mg pred even though the HPA axis isn't producing cortisol properly or even at all (it is still producing everything else).
It isn't unusual for patients to discover that even as little as 1mg of pred is plenty to keep the inflammation under wraps and the symptoms at bay. Don't rush - you have done well so far, don't spoil the ship for a hap'th of tar. It would be a shame to chuck such a low dose of pred and then discover you are back at square one after a few months - which in my experience more often than not means having to go back to at least 10mg to get things under control again.
369pd TonChe
Posted
For the year to 18 months prior to my diagnosis of PMR I was tripping over a sixpence, walking into doors and smashed every glass in tbe house. It continued on higher doses for a while then settle a bit. I can still trip over nothing if tired or flaring.