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Small Dose Prednisone Therapy

Polymyalgia Rheumatica (PMR) | Last Active: Apr 19 10:17am | Replies (14)

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@glinda47

Thanks Emo. I want to avoid steroids at all costs due to already having all the side effects associated with it.
There has been little research on PMR ergo pred remains the go to and works well for most people who can tolerate it. I'm also turned off by the fact that docs don't do enough digging and looking for possible infections or other reasons for this condition and just throw pred at it. I would also have to take osteo infusions and that's another group of drugs I can't tolerate.
Tell me, now does PMR put one in danger? Thank you.

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Replies to "Thanks Emo. I want to avoid steroids at all costs due to already having all the..."

My Rheumy was quite clear in stating that PMR is very debilitating but doesnt do any actual damage to joints and muscles. The damage is done by avoiding movement due to the pain experience. Prednisone takes away the pain by dampening the inflammation but causes a lot of damage and often doesnt 'reboot' the immune system in a sustainable manner.

That’s understandable. Apologies for the delayed reply. I agree it’s frustrating treatment options are limited seemingly because no one is researching it. I have several intertwined chronic conditions that are like that but don’t have an established “go to” treatment, so in a weird way, it was somewhat a relief that my dad’s PMR did not have to involve various trials of medications over months to identify the correct medication.

I’m a patient and caregiver so can’t say with 100% certainty, but it’s my understanding that untreated PMR would be unlikely to be life-threatening, but there’s still the risk of developing GCA, which does have severe risks. Then there’s the potential effects of the inflammation.

I did find this on Medscape because your question made me curious: “Untreated patients often feel unwell and have an impaired quality of life, but generally, PMR is not associated with serious complications.”

To your point, the next sentence is: “ Patients treated with corticosteroids are at risk for long-term complications of corticosteroid therapy.”
https://emedicine.medscape.com/article/330815-followup?form=fpf#e1
In my dad’s case, he had the debilitating fatigue and pain that’s indicative of PMR, such that he couldn’t get out of bed. I don’t even have words for how terrible he looked. He couldn’t walk, could barely make it to the bathroom, or even sit up in bed. He had headaches, light sensitivity, and fever. Forgoing treatment was absolutely not an option, and I doubt OTC medications, supplements, or lifestyle changes would have made a difference. He was sick for at least a month before he was even diagnosed correctly, which may have resulted in such severe deterioration of his physical function.

Most people I’ve met through this group or in talking to my dad’s doctors have PMR pain that’s severely limiting.

I suppose like most things, it comes down to a personal choice and a quality of life decision. If you and your doctor are certain it’s PMR (as others mentioned; there are a lot of “mimics”) and you don’t feel your quality of life is severely impacted without treating it with prednisone, then or may not make sense to treat it, at least not that way.

Are you certain of the diagnosis?