1. Community
  2. Bones, joints and muscles
  3. Polymyalgia Rheumatica and GCA

which pain is which

Posted , 6 users are following.

steve_1
steve_1

I've was diagnosed 14 months ago and have been on preds since then, starting at 15mg and reducing til 7mg now.

Like a lot of blokes in their 60's I also suffer with OA, and to cap it all I'm living with the aftermath of shingles. As you can probably immagine, life can be a bit of a pain at times.

My question is this.....How do I distinguish PMA pain from OA pain (they are easily confused, well my doctor first diagnosed PMR as OA till I insisted on blood tests) from PHN pain. They all hurt but one pain is very much like another and I'm finding it a bit tricky jugling the medication.

I take Preds for PMR and have been told that it probably helps with OA. and I take Tramadol for PHN and this seems to alter the way pain is precieved rather than killing it and Amitriptyline for nerve pain. confused

0 likes, 5 replies

5 Replies

  • tina-uk_cwall
    tina-uk_cwall steve_1

    Posted

    Hello steve, I'm sorry you seem to be going through it at the moment. I presume oa stands for osteoarthritis? In which case I cannot offer any advise regarding the similarities of the pain of PMR and osteoarthritis.

    however the pain of phn is a different I think and can be treated with a drug called gabapentin. If the gabapentin clears up the phn pain then the pain that is left will be PMR or osteoarthritis pain. Am I being a bit simplistic? Also I don't understand why you have been prescribed tramadol for the phn pain when gabapentin is actually the recognised drug for that pain. Throughout your PMR journey has any of your PMR pain got better especially when you were first on 15 mgs, I ask because hopefully if your over all pain has got better then the prednisone is doing its job and at every reduction you should not experience any additional pain because that would mean that perhaps the new lower dose is just yo low at present. I am not medically trained so I'm just thinking out loud, but in your case it could simply be a process of elimination. But think on about gabapentin as it does not have as many side effects as tramadol. Christina 

  • mrsmop
    mrsmop steve_1

    Posted

    https://patient.info/health/postherpetic-neuralgia

    I have just been reading this, you may have read it.  How long since you had shingles?  It sounds as though the PHN pain can come and go and the Tramadol and Amitriptyline appear to be the best combination to treat it.

    Reading your post, suggests to me that the pain you are currently suffering, is more, as a result of the shingles, than your other problems.  What does anyone else think?

     

    • steve_1
      steve_1 mrsmop

      Posted

      I've been suffering on and off for about nine years with recurring shingles, isn't this auto immune deficiency wonderful? After the first four attacks the doctor suggested in hushed tones HIV but the necessary tests disproved that theory. In cases like this the anti viral medications don't do a lot, well, in my case they didn't. 

      The problem with trying a process of elimination is that when medications are ceased or reduced, and later that ailment is  eliminated getting back on track can be long and painful, and in some cases, the increasing of medication to gain the same information is fraught with drawbacks.

    • EileenH
      EileenH steve_1

      Posted

      Antivirals in shingles only really work by taking them immediately when the virus is active, when you have a rash usually - as I understand it what you now have is post-shingles neuralgic pain and that is a "how long is a piece of string" question and amitryptiline is the basic answer there. there are other medications for nerve pain - similar but different. Maybe a trial of one of them may help?
  • MrsO-UK_Surrey
    MrsO-UK_Surrey steve_1

    Posted

    Yes, I echo mrsmop's comment that the nerve pain from the shingles is probably overriding everything else at the moment.  If you got in quickly with the anti-viral medication then the duration of shingles should have been shortened and the ongoing nerve pain reduced.

    I can't help with the Tramadol other than to say that the first Tramadol pill I took knocked me for six almost instantly, so it was the first and last.

    If you don't already eat plenty of oily fish, then adding that to your diet a few times a week will help to ease not only the symptoms of PMR but also those of osteoarthritis.

    I do hope you will soon feel better. 

Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.