Withdrawal Pain

Posted , 5 users are following.

I know that tylenol (paracetemol) doesn't help PMR pain.  Does it ease withdrawal pain?  If tylenol does help relieve withdrawal pain it might help me pin down what's what in the early stages of a reduction.

2 likes, 12 replies

12 Replies

  • Posted

    Hi Jean, I am afraid I cannot answer your question as I am only a newbie, I was diagnosed in November last.  One of the more qualified ladies will answer your question/s.  So hang on in there and someone will get back to you.  Good luck

    Pat

  • Posted

    Sorry jean not sure what sort of withdrawal pain unless you mean when u reduce pred to a certain level then the pmr pains return if so then yes because I have been trying to get down to 11mg and as soon as .....then the pmr pains return big style hope this info helps and good luck but always remember someone in this forum will be worse off than you and me
  • Posted

    I honestly don't know - I wouldn't have thought so though.

    We have always suggested that steroid withdrawal pain will almost always start immediately you reduce the dose and then would improve slowly over the following weeks. It is your body objecting to something being taken away.

    If it is a flare - you have to assume that, since you have felt well enough to reduce, your old dose was enough to manage the inflammation and prevent PMR pain. That means there is little or no inflammation on the day you reduce the dose - but it will then start to build up over the following days or even weeks. So if it is a flare, the pain will take some time to manifest. 

    That is the basis of the "dead slow and nearly stop" reduction - you only try the new lower dose on a single day at a time, spending the other days on the old dose that was "good enough". I feel a bit "funny" on that single day the first few times - and then my body seems to get the idea and accepts it is OK. That is the sensation I identify as "withdrawal". I did get down to 3mg and was fine getting there. After about a month at 3mg, however, I started to get cramp in my biceps and that seemed to get more obvious. I went back to 4mg - and the bicep cramp has almost gone. 

    • Posted

      Eileen, I really am in a dilemma.   Please bear with me while I try and explain my recent experience.  I began the drop from 18 to 16.5 on November 28 using MrsK’s reduction plan, which has been working well for me for 8 months reducing 10% each time. 

      I was on 16.5 for much of December.  I tried giving myself a Christmas present and did a drop to 15 on Christmas Day, but thought better of it as I was away and stayed at 16.5 until I got back home.  I reduced to 15 mg on January 2nd.  When I reached the point of doing 3 consecutive days I got progressively increased pain in my arms and across my neck and shoulders.   I chickened out and went back to 16.5 for a couple of days and then did a drop to 16.  I was OK with the 1 day and 2 day drops, however, when I got to the 3 days at 16 the same pain reappeared.  I decided to persevere and it eased off.    As I head for the 4th day of 5 days at 16 mg the pain is back!  I feel like I should keep persevering, but I’m not sure.

    • Posted

      jean39702

      Taking a drop over December thro February is a  'no no' in my book .   Go back to where you are comfortable 16mg and wait.  Too much stress in the run-up to Christmas and then you need January to settle back down.  If the weather is lousy, skip February as well.

      If the weather improves you could, at the end of January try taking a 1mg drop.  If that does not work and you have 1mg tablets, get a pill cutter and split the pill and take a 0.5mg drop.

      It could be that the 1.5 drops are too big.

      It is not a race, the aim is to get as low as possible where you are comfortable and a wait of two or three months in the great scheme of things is not long.  Tortoise won the race.

    • Posted

      Hi Lodger.  You make me smile.  :-)  Actually there was very little stress for me over the holidays.  It was the most relaxed Christmas and New Years in any years.  Although I was visiting at my sons I was totally catered to and had a lovely time.  And it's even wonderful back home because we're havng wonderfully mild temperatures.  I know -15 isn't mild for some, but it's usually at least -25 here at this time of the year.  It's like Spring.  :-)  I'm retired and spend most of my days relaxing other than prepareing meals and doing only light household chores that need to be done from time to time.

      Actually, I'm only attempting a .5 drop by going to 16 at the moment.    

    • Posted

      I'm another one not quite sure what to do.  I had decreased to 4mg on Nov 4 (or there abouts) and had no symptoms even after minor surgery.  Since I was away and would be returning home for Christmas I stayed at 4mg over the holidays.  Since I was doi g well I thought I'd give 3.5 a try. I started the slow nearly stop method on Jan.4. 3.5 then 4 etc.  All seemed ok until this week with aching in my behind and I went for a short walk today and felt weakness in my legs again.  Do you think I should stick with the program or go back to 4mg?  I know you've been at 4 mg for some time and still have trouble getting lower.

      thanks, Diana

    • Posted

      Go back to 4mg. 

      Again - you are NOT reducing relentlessly to zero! You are looking for the lowest dose that manages the symptoms. The reduction programme makes that journey more comfortable and also allows a more accurate pin-pointing of the lowest dose since if you go down in big steps you can overshoot the mark very easily - and 1/2 mg lower is better than 1/2 mg higher for obvious reasons.

      But as long as the underlying autoimmune disorder is active it is causing inflammation which needs to be controlled to manage symptoms. That means you need some pred. 4mg is a low dose with minimal side effect - if I stay here for life, that's fine by me.

    • Posted

      Whilst -15C is notably milder than -25C by anyone's standards - it is still an awful lot colder than the human body is designed to function at! And it isn't just temperature - other aspects of weather can have an effect, expecially humidity and pressure changes.

      It could be the gap you are trying is too big - or there could be something else going on. That is a highish dose for pure PMR problems to return - is there a physio around who could check for hard and unhappy muscles?

      The other thing to try would be staying at the pattern where you are OK for a few more cycles and then try the next pattern change again. It may be steroid withdrawal - sounds as if it could have been at the 3 day at 16mg since it eased off. 

      But do wait for a few more thermal units!!!!

    • Posted

      Thanks Eileen.  The pain eased off yesterday as the day progressed so I stayed with the 16 mg for last night.  (You may recall that I take my meds at night.)  I'll persevere for now and see how it goes in the next few days.

      I'm heading out to Victoria, British Columbia next weekend and the thermometer will be back in the plus range. :-)

    • Posted

      I forgot to mention that I will be giving Bowen Therapy a try for my back and hip issues (discussed at an earlier time) while in BC.  It's taken me ages to track down a therapist in areas I visit.  Perhaps that will help with the neck and shoulders too.   

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