really painful ribs

My Prednisone treatment started some months into it, by the time I began on 15mg of pred.

I can't recall a single prednisone-specific symptom, only a loss of pmr symptoms from taking pred.

The pred does however seem to eliminate my severe seasonal allergies, even at just 5mg, and also reduces the normal post-exercise stiffness I would ordinarily endure after hard cycling in the hills here, something I still enjoy.

I lost 23 lbs from the PMR which brought me from a medium size to small or a snug 10 to a 6.  I was starting to be concerned but I think it's stopped now.  Been the same for about a month.  Went on prednisome in March.

Sometimes, I feel a little lightheaded sort of like my head is screwed on backwards but if that's the worst I can live with it.  I had two flares at 10 mg so I'm on 23 mg now from 25mg. Going to take it a lot more slowly this time.

When suffering from both PMR and Fibro at the same time, it can be difficult to tell the difference especially if you haven't experienced either one on their own previously and got used to recognising the symptoms of each.

A list of comparisons was published by the Fibromyalgia Association UK a few years ago which may help:

Polymyalgia

Affects people over 50 years

An inflammatory condition

Symtpoms of severe pain, stiffness and tiredness

Can be accompanied by inflammation of the arteries

Treatable with steroids

Responds well to treatment

Many side effects of steroid treatment

Good prognosis - generally lasts 2-3 years

Fibromyalgia

Affects people of any age

An abnormal pain processing condition

Symptoms of widespread chronic pain, persisten fatigue and non-refreshing sleep

Many associated symptoms including cognitive dysfunction, IBS and anxiety

Treated with analgesic painkillers, low-dose antidepressants and lifestyle changes

Treatment response is variable

Variable prognosis - symptoms can improve but can last many years

Fibromyalgia causes symptoms related to nerve pain.

PMR (which means many muscles in pain) causes pain in

muscles and connective tissue......due to auto -immune

inflammatory disease.

Like I said,   very simple explanation

I was sent to a neurologist for an EMG and other tests and the result was I didn't have any nerve issues. So that ruled out fibermyalgia for me I guess.

Is there a simple way to tell the difference between PMR and Myofacial Pain Syndrome? Maybe this is where it gets harder. My second rheumy was hanging on to MPS as my diagnosis when he could have ruled out PMR by encouraging me to take the the prednisone. Doesn't this seem like a no brainer?

I don't understand why they have to insist on the either/or diagnosis - the expert I discussed it all with was quite clear: they happen alongside each other.

    thanks

How does it work? The lord only knows but it DOES work - ask lodger! It is supposed to realign the muscles and their attachments and stimulate them to "heal" themselves, or at least stay where they should be  Joanne always says that if it is going to work it will be apparent within 3 session - lodger walked out of her first session and forgot the walking stick she'd needed to get in an hour earlier! 

I've had PMR for well over 10 years now. They had no idea what it was and for 5 years I managed with nothing but the odd ibuprofen tablet but did aqua aerobics in the morning whilch got me moving, Pilates once or twice a week (adapted) and a yoga class (also adapted) and bowen every few months. Then PMR hit like a 10 ton truck not long before we moved here where the aqua and pilates are only a VERY expensive option that would cost a small fortune. I eventually was given 6 weeks (only) of pred to cover a trip to the US and 15mg provided a 6 hour miracle. The rheumy wouldn't listen, he wanted it to be anything but PMR, but a different GP who had only been parttime when she was there and had mostly been on maternity leave recognised it immediately. Soon after we came here.

Just over 3 years ago I had a major flare - the type of corticosteroid they use her just didn't work for me and that combined with myofascial pain syndrome had me in hospital. Then they put me on a statin - one week and I was in a state of collapse! I stopped pdq. The treatment I got then sorted all the MPS out but the PMR was still something of a pain until my GP put me on another sort of pred which worked as well as the original prednisolone I'd had in the UK. Using the "Dead slow and nearly stop" reduction I've got down to 5mg - I've been down to 4mg but feel far better at 5mg. It's the slow reduction and tiny steps that has made the difference I'm sure.

Can I get lower? I'll be trying but not forcing anything. My GP is perfectly happy with me at 5mg so doesn't make a fuss. I don't see a rheumy, don't need to as she is rheumatology trained.

You can't compare yourself with anyone - your journey is for you alone. It might all be done and dusted in 2 years - or it might be 5 or even 7 or more. PMR came when it wanted and it will go when it wants - nothing you or anyone else can do will change that. Your job is to make the best job you can of finding the lowest dose that manages YOUR symptoms - not anyone else's. Just because Mrs Positivethinkingcuresall says it only took her 6 months - you aren't her...

Are neck and shoulder pain not part of PMR?

Anyway it seems the only way to know if you have PMR vs MPS is to try the prednisone for a couple of weeks to see if you get a dramatic Improvment. The doctors are looking for a 70 percent improvement.

NSAIDs are NOT the only treatment for MPS - in fact, they do very little and don't target the cause of the pain, just mask it. Physical therapies and targetted injection or needle therapies are particularly helpful but not always easy to get - they are available in the USA, are almost unheard of in the UK and common in mainland Europe (I've had them). If you google it and look at the Mayo Clinic site you will find quite a good article which describes the various options and points out you may need to combine several to get an optimum result. 

Interestingly - while reading through the Mayo article they say some people think MPS may progress to fibromyalgia which was something I had never come across before. Earlier on someone asked about the difference between PMR and fibromyalgia - the fundamental difference is that most of PMR pain responds to 15-20mg of pred, fibro pain does not. There are a lot of overlaps, I had pain in about 12 of the trigger points they quote in fibro and I had pain when pressure was put on muscles - but that is also listed as a symptom of PMR. I responded like magic to 15mg of pred and, since I had managed the MPS and PMR for some years, to start with I was fine. Having moved here to Italy I had given up the self-management things as they weren't available or affordable here and gradually they built up again. The Medrol (methyl prednisolone) I was put on as the standard corticosteroid here, didn't work for me and I developed a major PMR flare, ending up in hospital. Using the techniques mentioned in the Mayo article, the pain clinic here were sorting out the MPS part and then I was put on a form of prednisone - and had the same magic PMR response I had had originally, more than 70% improvement in a couple of days. As the MPS improved with manual physiotherapy techniques to mobilise the trigger points together with needling techniques and injections, I was also able to reduce the oral pred. Now I have almost no MPS problems and the PMR is also well managed at 5mg.

To achieve freedom from pain you have to deal with the underlying causes of MPS and it can be done. Depending on the rest of your medical history it may return - it can be due to poor posture or other things, like PMR, which lead to muscles being put under strain - and then ongoing therapy is required. It may not be every week, maybe every few months or even, if you are lucky, every year or two. Those of us who use Bowen therapy also tend to have "refresher" sessions - sometimes because of a twinge or pain but also prophylactically every 6 months or so. Some people treat themselves to a massage or a facial - I enjoy a couple of sessions of Bowen as if it were massage as it leads to a floating feeling or well-being for me. I'm not the only one.

It isn't uncommon for rheumatologists or orthopaedic specialists to say muscle disorders such as MPS and its effects can't be cured - physio or physical therapists often have a very different view. It was said to me - and the physio I saw when I was in hospital was horrified. Had I seen her rather than the doctor I would have had far less pain over a 2 year period. But our system has an exemplary pain clinic which doesn't just teach people to manage their pain - where possible they will target the cause of the pain. The anaesthetists who run it are sent for courses on these techniques, something for which I am heartily grateful!

thanks for the clarification and I definitely misspoke about MPS and NSAIDS. What I meant is that it has no miracle med like prednisone to help stop the symptoms.

Have you heard of something called "dry needling"? My PT group does dry needling to release trigger points. 

Also when I get acupuncture treatments, sometimes my acupuncturist hits a trigger point which provokes a much bigger reaction than the points she usually treats in the acupuncture meridian system.

Acupuncture before I got the pred med, was providing much more relief than anything else I tried. The only problem was its last power was short --a few hours to a day.

Another thing I have been using is cho pat strap which is a band that presses on a tight muscle in the leg. After walking around a bit the muscle tends to release and the pain diminishes or goes away.