Why pain reduces
Posted , 9 users are following.
Does anyone know why PMR pain decreases during the day?
It was also before pred that the pain decreased during the day.
Any help appreciated.
0 likes, 18 replies
Posted , 9 users are following.
Does anyone know why PMR pain decreases during the day?
It was also before pred that the pain decreased during the day.
Any help appreciated.
0 likes, 18 replies
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nick67069 margot34956
Posted
margot34956 nick67069
Posted
stevep63 margot34956
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EileenH stevep63
Posted
It really is yet another "everyone is different" - I know quite a few people who find that not too severe PMR improves through the day as mine did in the aquafit class. And alpine skiing also helped - especially my hips!!!!
margot34956 stevep63
Posted
That's really interesting Steve, I will look up RA. Also approach Doctor. Thank you
EileenH margot34956
Posted
Once you start to get moving and the blood flow improves to the muscles then some of the pain fades, especially if you manage some gentle stretching in a warm shower for example. But it doesn't happen for everyone. I had 5 years of PMR without pred and every morning Mon-Fri I did an aquafit class in a warm pool. The earlier I did it, the better day I had. Especially when I had time to spend in the sauna or steam room. So I assume that it is vasodilation - the blood vessels becoming wider and allowing better blood flow to the muscles.
margot34956 EileenH
Posted
That certainly seems to be the answer. Thank you Eileen
why did you not take pred for 5 years if you don't mind explaining?
It is with movement, that the pain decreases, if I stop moving for a while, pain and stiffness is back.
EileenH margot34956
Posted
Because it was beyond the wit of my GP to work out that even if my blood markers were "in normal range" there was something other than "depression", "your age", "somatism" going on. Had I been sensible and worked my way around the GPs in the practice I might have found one who recognised what it was and done something. Even the rheumy I eventually saw didn't think it was PMR - despite a miracle in under 6 hours with 15mg of pred!
The return of pain and stiffness if you are still for a short time is called myogelosis and is a typical finding in PMR. The doctors seem less aware of it though - they become fixated on "morning stiffness" which is often there but not always and patients often say "all day" which fools the doctors...
margot34956 EileenH
Posted
Sounds like you've not had much help from your GP or rheumy, it's so hard to know, when you trust the medical professionals . I no longer trust them. Thanks to you we are being informed.
Bless you!
connie28112 margot34956
Posted
From what I understand, pain & inflammation levels follow the body’s levels of cortisol, which is a hormone & natural anti inflammatory. Cortisol levels dip overnight to become their lowest in the early morning. Body inflammation is highest then. Cortisol levels increase throughout the day, into the evening.
margot34956 connie28112
Posted
Oh that's interesting, I wonder if there is any way to take or bring cortisol levels up, that might be worth investigating.
Thank you for your reply
EileenH margot34956
Posted
It has been said by experts that. although a small number of people do have poorer adrenal function before developing PMR, it doesn't play a role in PMR itself. It is the malfunction of the immune system that causes the pro-inflammatory substances to attack the body. The cytokine IL-6 which is the one that causes the trouble in PMR/GCA is always present in the body and plays an important role in several processes - inflammation is an essential part of healing damaged tissue. But something goes wrong - and the cortisol doesn't play any role in that as far as they can tell.
margot34956 EileenH
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Anhaga margot34956
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margot34956 Anhaga
Posted
Thanks for your reply. I hope you are doing better
Anhaga margot34956
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Thank you. Pred has pretty much eliminated all my PMR symptoms, including what is called the "gel" phenomenon - when the muscles stiffen up with even a short period of inactivity. I think if one experiences that while on pred the dose is not quite high enough. There are other causes of stiffness, of course, and I have one of them, osteoarthritis.
Anhaga
Posted
should add, after "the dose is not quite high enough" : "or after a taper there is a bit of pred withdrawal which should go away in a few days".
margot34956 Anhaga
Posted