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temp diagnosis pmr, taking prednisone

Posted , 8 users are following.

cheryl74384
cheryl74384

well my gp started me on 40 mg prednisone 18 days ago,prior to getting my rheumatologist appt, on oct 25th, he tapered me to 30 mg before seeing her, my initial visit with her resulted in some confusion for me, after studying the limited information she had, ie,blood tests prior 2 wks, shoulder xray,ultrasound, prior 2 weeks, and mri had done in july, showing some back issues, she ended with saying, she couldn,t confirm pmr diagnosis, with all back issues etc, could be cause of pain in glutes and hamstrings, and shoulders could be tendonitis ? she needed more infor from gp about me, my history, bone density, lung xray had done last january at physical, more blood tests etc, this has left me nervous, stressed as to what else could be going on with me, she instructed me to taper to 25 x 3 days , then 20 until next visit to her nov 7th, also to get bloodwork done after 4-5 days on 20 mg of prednisone, has anyone out there had this situation, taking a long time to confirm pmr diagosis, 

0 likes, 6 replies

6 Replies

  • nick67069
    nick67069 cheryl74384

    Posted

    yes... there is no direct test to diagnose PMR. Basically rheumi checks that there is no other reason for inflammation ( any infection or cancer, for example).  I had ct, mri and number of other tests before being diagnosed. Testing is typical... what is not typical is that you have started at 40mg of prednisone. Usually is 15-20mg.
  • amkoffee
    amkoffee cheryl74384

    Posted

    On the other hand I already had a bad back. And really nothing but my blood work and my pain was the only thing that was considered in my diagnosis.
  • Daniel1143
    Daniel1143 cheryl74384

    Posted

    My diagnosis took a year with multiple Rheumatologist debating whether it was PMR, LORA or something else.  Painful process.  My blood levels have always been normal, so typical blood markers were absent.
  • whitefishbay
    whitefishbay cheryl74384

    Posted

    I've had PMR since Oct 2016 & went to rheumy again two weeks ago & after ultrasounds and X-rays he still calls it probable PMR. Aargh.Frustrating. 'What am I? Chopped liver?'

  • EileenH
    EileenH cheryl74384

    Posted

    Took me 5 years to get a diagnosis - and then it was because I told the GP what it probably was. He sent me to a rheumy. Like Daniel I have no raised blood markers.

    If your GP started you on 40mg that was far too high a dose for PMR - had they put you on 15 or 20mg and you'd had a good response from the stiffness and pain the rheumy might have been more convinced - lots of things will respond to such a high dose. It isn't unusual for a rheumy to then ask the patient to reduce so they can see better what is going on. You don't say if you are better since you have been on pred either?

    However - I also have back problems due to myofascial pain syndrome (MPS) which causes pain in my glutes and hamstrings as well as shoulders and neck. It is something that is often found alongside PMR and is caused by the same inflammatory substances as PMR except they are in specific trigger points which are found in pairs on either side of the spine in shoulders, about rib level and low back whereas in PMR they are systemic - i.e. all through the body. Higher doses of pred often help MPS but they take a while to work - and then the problems may return as you lower the dose. MPS is better dealt with by targeted treatment - manual myofascial release or steroid injections often work well.

  • iellen32
    iellen32 cheryl74384

    Posted

    It seems to me just one doctor doing the tapering

    will be the way to do.

    The markers and your symptoms - both considered by the professional who is in charge will work better for you.

    Good luck, all the very best,

    iellen

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