upper back painm

Gillian,

I have had upper back and rib pain ever since staring the PMR.  If I lay back on a hard floor, my backbone is very painful.  The pain seems to spread along the lower right rib.  My sternum is also affected.

I think that the symptoms of the back pain have increased since lowering my dosage of prednisone from 20 mg to 8 mg per day, but I'm not sure.  

That's my experience.

All the best,

Hello gillian, prior to diagnosis and therefore pred in my last 2 weeks pre diagnosis my rib cage hurt me unbelievably but at the front and side but not the rear. I also developed a terrible pain at my left hand sternum/breast bone. The pains went went when I started on preds but when I had a flare whilst reducing from 9-8mgs the painful rib cage returned. The pain at my sternum has never really gone, it is always there niggling although the pain is much much reduced.

regards, tina

That's the biggest annoyance about this disease.....never really sure

 if the pain is PMR or something else.    We all have pain of some kind,

somewhere and to have to guess is really another kind of pain to have to

deal with......

Yes like it effects breathing, but I was having a flare at the time but now it's gone 

I hate being so breathless at times. Is this how you are affected?  

Drs can't tell me why.  Had several tests and x-Rays ..no abnormalites

found. Worse when I am tired.

Yes - and the hand and wrist pain. Loads of people complain of how much stuff they dropped in the early days. I couldn't grip properly at all.

To return to the back pain - there is something called myofascial pain syndrome which is very often found alongside PMR. It takes the form of trigger points in pairs on either side of the spine: in the shoulders, about rib level and in the lower back where the dimples are on a baby's bottom. These trigger points are concentrations of cytokines, the same substances that cause the pain and stiffness of PMR but in PMR they are all over the body. 

They can be reduced by cortisone injections around that area - but also using manual techniques of mobilisation which can be done by physiotherapists or sports massage therapists for example which would be better for you probably. They can be felt as hard knots in the muscles which tense around them to try to prevent the pain - which in itself causes pain. Warmth helps in the short term but the only way to get long term relief is proper treatment. The spasmed muscles can be tight around nerves and this gives rise to referred pain in the areas supplied by those nerves. Deal with the spasmed muscles and the rest of the pain improves. I had it and they used both cortisone/muscle relaxant injections and mobile moblisation. I also got a lot of benefit from Bowen therapy though whether Bowen alone will get rid of the entire problem I don't know.

If what you have is PMR you are not so much in a flare as the inflammation is back because you have had to stop the pred. Methotrexate rarely does much for pure PMR - it MAY help people get away with a lower dose to manage the inflammation but on its own it doesn't. If it alone worked I'm sure they'd use it for most of us. Inability to get up out of a chair (or bed) is very characteristic of PMR.