Rheumatoid Drs

Ah. That makes sense. My brother had something like that when he blew his knee out on a Ski slope and they had to divide a ligament on the slide of His Knee and attach it in the middle where the ligament was too messed up to use.

RA is quite a different disease. My rheum was telling me that PMR is not classified as a arthritis. The PMR disease process is not happening on the surfaces of our bones at the joints, creating permanent damage. PMR happens in connective tissues, particularly where connective tissues join muscles and bones, and typically does not lead to permanent bone damage. In fact, it may not lead to any permanent damage at all as it faces and wanes over the natural course of the disease.

Just wanted to point that out.

Hello @bren0718 do you live in USA ? I ask because you us the term family doctor, not PCP. to learn about PMR i suggest this site : https://www.pmrandil6.com/

Look at all the slides , under resources tab scroll down to the two videos. In UK , PMR is mostly managed by Primary care physicians- so not unusual - my experience was that my PCP would NOT increase my prednisone dose above 15mg, which is what i needed for 100% relief of morning pain and stiffness. I was able to see a rheumatologist in 1 month in Boston -area.

BTW @pb50 it is well recognized the PMR is an auto-inflammatory disease - not auto-immune.

the attached papers helped me understand PMR -

Yes. I’m aware. I was diagnosed 12 years ago with an acute, terrifically painful onset in ankles, hips, shoulders, - and hands. The Rheumy then said I had symptoms of RA but large joint areas were more emblematic of PMR. I was sero negative but we agreed to treat as RA and see what happened. So I went home with Humira and it provided dramatic relief.
Over the years, I evolved to sero positive. But I still have large joint involvement as well as more classic RA sites. I have weakness and pain in my hands but virtually no swelling ever and joint damage barely beyond what would be age appropriate. I do have frequent trigger fingers and have had three surgeries to release them.
I’ve been on multiple biologics and am on Remicade for four years now. When I flare - as I recently did with pain in shoulders, knees, ankles and hands - I was given Prednisone to augment my Remicade.

So I stay abreast of both diseases and continue to have symptoms of both.

My PCP first made the diagnosis in Jan 23 and he has been on top of this since day one. He knew that Kevzara was in clinical trials and his goal was to get me off prednisone ASAP.
I came off prednisone entirely 1year after diagnosis and off Kevzara last month but it is my go to in case of a flare. I am really sorry that your doc does not seem to being as attentive to PMR.

What you say is true. However, there is nothing that prevents a person with RA from developing PMR. The same is true for people with PMR who also have osteoarthritis. You can have any type of arthritis and still have PMR. It doesn't have to be one or the other.

I was diagnosed with spondyloarthritis at the age of 32. My prior diagnosis did create some confusion when I developed PMR at the age of 52. My rheumatologist eventually just said it was "unfortunate" but I had both.

In my case, PMR exacerbated my arthritis to the extent that I didn't know what was causing what --- it would hurt everywhere. My rheumatolgist called it "systemic inflammation." Another phrase used was a "full range of rheumatology conditions." I personally thought it was a "hybrid of things."

All I knew --- whatever "it" was --- the pain wouldn't stop unless I took a lot of Prednisone for a very long time.

Gosh I appreciate everyone taking the time to educate me on the differences between PMR and RA. I will just say that my Rheumy in NYC was quite comfortable advising that I had symptomatic overlap but it doesn’t matter. We treat with an anti-TNF and If I have a period where the anti-TNF isn’t addressing the pain, prednisone will. So to me - I understand distinctions between the two quite well - I just also understand that sometimes the difference is without distinction.

I'm in the same boat except an IL-6 inhibitor (Actemra) works better than a TNF inhibitor (Humira). I can't say Humira "failed" but I needed Prednisone to supplement Humira. That was disheartening to me because I was able to get off Prednisone completely with Actemra.

My rheumatologist asked me which biologic worked better for me because I couldn't take both Actemra and Humira. He added it would be impossible to "optimally treat" two different conditions or more than two with a single biologic.

It was entirely my choice to take Actemra. My rheumatologist agreed with my decision saying it was better than being on Prednisone for the rest of my life.

My ophthalmolgist wasn't so pleased with my decision to take Actemra. She said it was just a matter of time until uveitis would flare up again.

I'm solidly in the camp that says whatever works best for you as an individual. At this stage, I have taken so much Prednisone, a supplemental dose once in a while probably wouldn't do any more harm than it has already.

I live in Lynchburg Va. I will have to travel to a larger city to get into a specialist. Still it may take up to 6 months to be seen.

Wow ... Lynchburg does look like it is surrounded with trees. I bet it is nice there. I live in the rural Midwest state of Iowa. I live in Iowa City which is a relatively small city. In Iowa, we don't even have what people consider a "large city."

Fortunately, in Iowa City there is a large university hospital. This hospital is too large for many Iowans who prefer their local doctors -- nothing wrong with that. Many local doctors will make arrangements for their patients to be seen by a specialist at the University Hospital. Depending on many factors, a "doctor referral" might be faster than a patient "self referral."

If transportation is a problem, the University Hospital has a fleet of cars which go out and pick patients up and take them home again. The specialists at the University are just "consulted" and give advice to the local doctors about the best approach to manage their patient's condition. The specialists at the University don't take responsibility for all of a patient's health care needs.

I had access to many specialists here in Iowa City. Too many specialists isn't ideal either.