Polymyaglia

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I was diagnosed with this condition in January 2017 and put on Prednisolone dosage of 20mg, then after seeing the consultant down to 15mg per day. I suffered weight gain, but my condition of stiffness and muscle pain went away. I then saw a different consultant who suggested that I should drop down to 12.5, then a month later to 10mg and then after each month reduce by 1mg. I was also prescribed Folic Acid, Acreed for bone protection, and Omeprazole to protect the stomach lining against the effects of the steroid. I finished my steroid dosage just over a week ago. I am still taking the other tablets and should finish those in a couple of days. However, I am now suffering withdrawal symptoms, feeling feverish, muscle pain, some joint pain and nausea

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2 Replies

  • Posted

    You have reduced to zero very quickly, polymyalgia usually takes at least two years to go into submission and often a lot longer. It may be that the polymyalgia is still there and may come back with a vengeance. 
  • Posted

    PMR does not often last such a short time although men do seem generally to do better than women. The median duration of PMR is 5.9 years:

    https://www.practicalpainmanagement.com/resources/news-and-research/polymyalgia-rheumatica-steroid-side-effects-new-findings

    You say you were prescribed folic acid - were you also put onto methotrexate? Folic acid is not generally prescribed otherwise.

    I think it is very unlikely that what you are suffering is withdrawal from the pred - you reduced to zero slowly enough to avoid that - but a resurgence of the symptoms we call polymyalgia rheumatica. The pred does not cure anything - it manages the inflammation that causes the symptoms and you are not reducing steadily to zero on a relentless programme but should be looking for the lowest dose that manages the symptoms as well as the starting dose did. The actual disease is not the PMR but an underlying autoimmune disorder which causes your immune system to be unable to recognise the body as self and so it attacks tissues in error, believing them to be foreign invaders.This causes inflammation - and the symptoms. Unlike many autoimmune disorders the cause of PMR does generally burn out and go into remission - for 75% of patients in 4-6 years. It is very unusual for patients to get off pred in under 2 years and when they do are often at increased risk of a relapse at some later point. As long as you are taking enough pred then the inflammation is managed and you have few or no symptoms. If you go to too low a dose, the inflammation mounts up and eventually causes symptoms again. For many people the longer term management dose may be as low as one or two mg but even such a low dose is necessary for freedom from symptoms.

    I would suggest that your doctor was not well informed about PMR - it is an approach I haven't come across before in over 9 years involvement with the PMRGCA northeast of England charity. There is also a PMRGCA forum on this site and this is a link to the homepage including our resources page, there is a link using the third pinned post:

    https://patient.info/forums/discuss/browse/polymyalgia-rheumatica-and-gca-1708

    Do come over there and join us - you will get plenty of advice and sympathy there! I assume you are in the UK - there are support groups in various places across the country as well as another very active forum on HealthUnlocked.

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