PMR, Prednisone, A Different Kind of Flare?

The pain is like the original PMR pain, except not nearly as bad; around the outside of my shoulders, my neck, inner thighs. So, are you saying the PMR activity has increased and can n longer be control by 7-1/2m of prednisone?

 

It really takes time(years) for us to get to know how our unless evolves and how in consequence how to translate our symptoms.

Because it is different for everyone it is understandable why our Rheumy doe not give us the right schedule of how to do the tapering thing!

It takes time, yes, but we are able to get to know ourselves and then the issue becomes less bad.

You are not alone!

More we read here the Forums more we learn with people who have a massive knowledge as EileenH more we will be able to help ourselves and eventually to help others as well.

I love to be able to help!!!

Keep safe, keep healthy, keep moving!

🌺

PMR is just the name we give to the symptoms - which are caused by an underlying autoimmune disorder which causes our immune system to attack our body tissues by mistake. The autoimmune bit varies in activity - while it is relatively inactive we can probably reduce fairly well and if we are lucky it will stay that way - but at times the autoimmune problem gets more active. Anything that will affect the immune system may do it; infections, overactivity or stress. Or it can just "happen". Overdoing things is a major reason for people flaring - as some RA patients found last week at the conference we were attending!

So flares may happen because the dose has been reduced too far (that's obvious of course) but can also happen because we push our luck or just because. A bit more pred may help - or just resting for a few days. But don't let it get away.

Once a flare (even a very mild one involving perhaps only fatigue) takes hold and persists over even a short period, I would say that another short-term boost in dosage is indicated.

Each of us has a different response to pmr activity, and for me I am quick to take advantage of the benefits of the boosted dosage by jumping my level of morning exercise back up to a familiar level.

Having more energy and free of localized bursitis pain, I can thus resume being active again, and free of the possibility of my shoulder or hip becoming painfully disabled.

Seeminglyly for metabolic and circulatory reasons, I have typically responded better to a slightly lower dosage of pred when I have a daily morning exercise routine firmly in place.

A couple of days of missed exercise, as brought on by bad weather, usually sets me back with a flare within just a few days.

Some pmr activity in some people may need to be rested away, and I can recall my shoulder (in and of itself) needing quite such a rest from even trying to vacuum my floors using a lightweight vacuum cleaner!

But in general, in my own case, it has more often been the other way around, i.e. that getting myself back up to the 2+ hours of morning exercise and/or physical work (of whatever type that my greater "skeleton" will tolerate) can get me back to feeling well at the lower dose within a few days.

Many times I have succombed to a period of general malaise (fatigue plus skeletal symptoms) and have failed to reel it back in quickly (by dosage boost and morning exercise working together). I have much regret about this, but I am learning to better recognise the problem and solution as relates to my own particular set of conditions.

interesting that you mention the morning exercise, that is my preferred routine...a couple hours of activity, then rest...combined with the correct dose of prednisone. I had never considered the actual "regimen" of activity having such an effect on how I feel. Will try to get back on track.

Appreciate your sharing your experience!😊

I think so too - still working on the medics though!

How do you keep it from getting away. I'm confused about it

             Thanks

If you stick your head in the sand and ignore symptoms that are more than likely to be a flare then the inflammation will build up - the longer you leave it the worse it will be. Then you will probably need to increase your dose a lot and start the reduction process again.

Think of it as a tap dripping into a bucket - if you empty out the bucket every morning it won't overflow, leave it and the water level will get to the top and pour out. If you stay at a dose that isn't enough to manage each daily new lot of inflammatory substances, the same happens with the inflammation, the residual amount builds on top of yesterday's left-overs. And eventually you will have a full blown flare.

But I have been playing tennis the whole time. It was when I started the reduction that I quit playng! That is why I am zeroing in on Dan's experience of 2+ hours of exercise in the a.m. as part of my routine.

Seems if I do too little I feel worse! I won't be reducing for a while!

thank you for all your thoughts!