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Why is there pain when one's CRP is normal and Dr. says inflammation is gone?

Posted , 5 users are following.

leonard12916
leonard12916

I'm confused!  I've noticed a few times here people have mentioned that their doctors have said their CRP was normal and the inflammation was under control, so why do they still have pain?  A few months back my CRP was in the low normal range and I still had discomfort as well.  I can see where a very high CRP would 'ring alarm bells', but my impression is that I am the best judge of what dose of Prednisone to be on and will make my best recovery using the 'dead slow approach' suggested here.  I also want to ask about those days I experience tremendous fatigue after a busy day.  Is this a manifestion of PMR, Prednisone, thyroid, or adrenal issues, or some combination of them?  Reading the posts here I notice fatigue is particularly prevalent if one is overly active. It appears as though PMR and Prednisone are major contributors here along wiith the inflammatory process likely being irritated somewhat.  I'd appreciate your comments here.

2 likes, 5 replies

5 Replies

  • EileenH
    EileenH leonard12916

    Posted

    Fatigue is always a part of autoimmune disease and the only way to manage it is rest and pacing yourself. The autoimmune disorder is still attacking your body even when the ESR/CRP are normal - even when you are taking the pred to manage the inflammation. 

    I often recommend people read a blog called Despite Lupus - Sara Gorman deals with the fatigue aspect very well.

  • constance.de
    constance.de leonard12916

    Posted

    Hallo Leonard.  I too thought if the CRP and ESR were in the 'normal' range then PMR was  'cured'.  That was before I joined this Forum over 7 months ago.  I soon learned differently.  Eileen has explained often that PMR is NOT cured.  It can go into remission, but can reappear at any time.  Some never have any trouble once the pred is stopped and are then pain, and fatigue, free.

    I had PMR for 3 years before I read the first post on here and I believed everything the doctor and rheumatologist said.  And that was "get off pred asap".  The result was quite a few flares (in the early days really bad, with 3 emergency admissions into hospital).  This forum has changed my life. I now listen to my body, and to my fellow sufferers advice.  THEY DO know what PMR is all about.

     

    • beatrice74480
      beatrice74480 constance.de

      Posted

      Yes me too ESR was 10 was managing on !mg pred daily, Rhuemy says stop pred within 10 days I was in great pain and stiff arms and legs, paracetomal did nothing for me, a blood test proved ESR had shot to 18 in less than two weeks, Doc said take 2mg Pred daily and after a week ESR down to 12, I will stay on this dose for a month and then have another blood check and hopefully start tapering to 1mg ,  Yes we know our own bodies best, I do get fatigue some days , good luck
    • constance.de
      constance.de beatrice74480

      Posted

      After 3 1/2 years my CRP and ESR always 'hover' around 18 -20.  I am now on 6 1/2 mgs of pred.  Both doc and rheumy say this is in the normal range!! I am often in pain, but it's managable, the worst thing is the fatigue.  But, hey, this is 'normal' ! 😞😞😞
  • misdiagnose
    misdiagnose leonard12916

    Posted

    Doctors, in my experience, bad ones, when it comes to reduction of prednisolone treat the blood test report and not the patient. I always ask my doctor 'do you want to ask me anything' and they usually (I've had 9 doctors in the past 18 months) say 'no'. 'You're not going to ask me if I have pain then?' Pain is a warning that there is something wrong! If a patient with GCA does not receive sufficient medication to reduce inflammation, they can end up with damaged arteries. The inflammation might be low but the damaged arteries struggle to deal with getting the blood through to where it's needed. This can lead to stroke, dementia and other major disabling disease. It is very difficult to find any studies online about this but I am assured on good authority that mismanaged GCA leads to serious consequences. Doctors, I think are covering themselves against litigation by not providing the information that patients need to prevent long term illness for what could be decades of their elderly years. 
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