Why can't or won't a GP diagnose polymyalgia?

i quite understand your frustration at the gp it certainly points to pmr and the standard treatment is 20mg/15mg starting dose of prednisolone steroids are not without there problems but given this is the only treatment for the symptoms not the condition it is the only course of action ,my one thought is perhaps the gp is reluctant to start your wife on steroids because of other health factors .once a consultant sees her and confirms pmr which quite frankly is proven by the positive reaction to the steroids ! the path is then set for a standard long progression of over a year where the steroids are gradually reduced according to the symptoms .please reseach pmr but do not accept all that is said on the nhs websites they are rather fairyland better to explore websites specific to pmr . please come back to us with any ?? did not want to bombard you with too much info that you may already know ,i do admire you for supporting your wife in this way i am sure she must find it very reassuring carolk

Thanks for your quick response Carol. There has been a further, small, development today. The GP has agreed to refer my wife to a rheumatology consultant who comes highly recommended in the local area. Unfortunately the consultant will only accept appointments after having sight of the referral letter. I suggested to the GP that this letter could be emailed to speed up the process but that seems to be far too revolutionary although it can at least be faxed.

I note your comments about possible concern over other health issues but one thing I didn't mention was that, in an effort to get to the bottom of the problem, we paid for a full BUPA health screening which she passed with flying colours! This medical didn't include a test of ESR or C-protein but this has since been covered through our GP, so we are very gradually making headway. There is little comfort in the websites that talk of spontaneous recovery within 2 to 6 years though! That's an awful lot of sleepless nights!

good to hear you moving towards getting a diagnosis ,although you do wonder why the gp has not commenced steroids as part of the dianosis of this condition is the positive response within 24/48 hrs of taking pred .a slight cautionary note i did not improve in this manner although i do have pmr and my crp went down from 39 to 15 in days !! however i am now a year plus on and the difference when you look back makes you realise how you can improve i went from someone who could hardly walk or dress and in bed exhausted by 6pm , to someone leading an almost normal life be it slightly restricted re tiredness and the odd off day ,so although this is a very difficult time for you both there is a little light glimmering but you will have some ups and downs so keep coming back to this and other websites at least you will hear the nity gritty but also good tips on how to manage the condition and the meds ,please do not assume gps know a great deal about pmr they know the basics but my gp says herself i know more than she does and i have only gained this from the website and eilleen our resident expert who i am sure will be posting soon best wishes to you and your wife carolk

I have had PMR twice and with my first bout my Dr was convinced I had PMR but my bloods were quite low ( my Dr now regards this as normal for me ) She repeated bloods and wanted to prescribe steroids but the Senior Partner refused and said Rheumy appointment first

Then the waiting time was 3 months so I went privately as I was deteriorating rapidly and becoming increasingly immobile Rheumy confirmed it and within a day I was a new person I took steroids for 2 years and sailed through the whole thing I was free for 4 years then unfortunately it returned but my Dr was then able to prescribe steroids immediately as it had previously been confirmed

I hope your wife see someone soon

Thanks Mrs G. Fortunately we do have private medical insurance so we hope to have an appointment with the rheumatology consultant within a couple of weeks, maximum. The consultant does require to see the referral letter first however and will then offer an appointment based on her assessment of medical priority. Fingers crossed!

Most GPs are scared of using pred unless they have had previous patients with PMR and have some experience. There are other things that can cause polymyalgic syndrome (the painful muscles) and they are supposed to be ruled out before making a final diagnosis of PMR - it is what is called a diagnosis of exclusion. If they had any concept of how ill ones feels and how handicapped one becomes they might be a bit hastier with offering a trial with pred.

Good luck,

Eileen

Chino

Your wife's symptoms sound so classic of PMR that I'm surprised her GP didn't intervene with a trial dose of 15mgs of Prednisolone to see if her symptoms resolved. If so then at least she would have been spared unnecessary suffering. If there hadn't been a reduction in her pain, then the pills could have been stopped after a week or so with no adverse effects. I do hope her rheumy appointment comes through quickly - good news that she/he comes with a high recommendation. How lovely that your wife has such a caring and concerned hubbie! Do let us know how she gets on.

All good wishes,

MrsO

Hooray! My wife saw the consultant yesterday who prescribed salazopyrin which the Internet tells me is an anti-inflammatory drug used to treat rheumatoid arthritis although the specialist said that she didn't have that condition. However, she also gave my wife a steroid injection and this morning - no pain, no aches, no weakness. She seems so full of pent-up energy that I may have to tie her down! The change is little short of miraculous. I have warned her that, as I understand it, the dose of steroid will be reduced to a minimum level to control the symptoms so she can expect to have some recurring discomfort until the stabilising level is reached but what a result.

Thanks everybody for your concern and advice.

Chino - so glad to hear that your wife is now having treatment that has relieved her pain. I haven't had any personal experience of the drug you mentioned - most of us with PMR are prescribed the steroid, Prednisolone. Do hope it continues to prove successful for her but, without going as far as "tying her down" :D do tell her not to overdo things so as to give the medication a chance to get full control over the inflammation. Magic though to get rid of long term pain.

MrsO

hi have they confirmed pmr having eliminated ra or are they waiting to see the response to nsaids and steroid injection if pmr there is a tried and tested regime will be interested to see what happens next ,so pleased to hear your wife has had a positive response to treatment but do remind her to rest at times !!carolk