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Trying to come down from 30mg without a flare.

Posted , 7 users are following.

diana21296
diana21296

I have been on 30mg for  6 weeks and need to bring it down.  3 days ago went to 25mg but had muscle weakness in arms (no problem as improved as day went on) but on 2nd evening had sudden flare in left hip making it difficult to walk.  Had gone the next morning, but 11.30 yesterday it appeared again with a vengeange.  Yesterday went up to 27.5 splitting the dose, but this morning still limping although not so bad.

How long do I persevere on the slightly lower dose to see if the limp will go or do I have to go straight back to 30mg for yet another 2 weeks as soon as flare appears?  I don't think my GP will necessarily know as the dose seems to be to leave the patient to manage it. Can you advise me please Eileen?

1 like, 6 replies

6 Replies

  • EileenH
    EileenH diana21296

    Posted

    I do wonder whether the hip pain is directly PMR - it could well be bursitis. What sort of pain is it? What makes it worse/sets it off?

    That is a very high dose for PMR, the more usual starting dose for PMR these days is 15-20mg for 6 weeks and even reducing to 25mg should still be plenty to keep PMR under control. A PMR flare also tends to be more like the start - bilateral. If it isn't bilateral then it really does have to be considered whether something else is going on - such as bursitis, which would also have responded to higher dose pred.

    I would go back to the GP and ask if the hip could be something else - bursitis and tendonitis are both common in PMR and respond better to local treatment with steroid injections. The weakness in the arms sounds fairly typically withdrawal wobbles and if that's OK then it would be a shame to go back up to 30mg.

    Or it could be something completely different!

    • diana21296
      diana21296 EileenH

      Posted

      Many thanks.  I was put on 30mg by the rheumatologist at the hospital on 22nd Dec I  presume because my bloods were up so high and the pain all over was awful. He told me to drop to 20mg 1 week later which I tried but couldn't do.  The ESR is now normal and the CRP almost there too.  I had bursitis 4 years ago in right hip through doing pilates and had a steroid injection and physio with acupuncture which helped considerably.   Yes, this does feel like bursitis to me albeit in the other hip but why would I suddenly get it as have only done a very small amount of walking recently and a bit of shopping and I know bursitis is caused through repetetive exercise??  The pain is now there all the time, even when lying in bed.  It started 2 evenings ago at 8.30pm, was gone the next morning and as I was on my feet preparing sandiwiches for visitors, came back at 11.30am yesterday.  Can hardly walk. I have tel consultation with GP so will take your advice an ask heri if I can have steroid injection.  Will have to wait tho. So annoying.Had no pain anywhere and could walk perfectly on 30mg.  Weakness in the arms has gone now.
    • EileenH
      EileenH diana21296

      Posted

      If it doesn't improve considerably please go to A&E - there is a small possibility it could be avascular necrosis and that needs to be ruled out with an x-ray. It isn't very likely given the speed its development but it can happen.
    • diana21296
      diana21296 EileenH

      Posted

      OK.  Will talk to GP tomorrow and do that.  Many thanks for your help.
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