Spondyloarthritis symptoms usually manifest at a younger age compared with PMR. I had lower back pain for no apparent reason when reactive arthritis was first diagnosed. I guess I was lucky to have uveitis too otherwise nobody would have believed me. I couldn't believe it myself. The pain was like torture almost immediately after falling asleep. I called my bedroom a torture chamber. Absolutely no pain when I was awake and moving around. I was diagnosed by a primary care doctor and treated with sulfasalizine. An ophthalmologist treated uveitis with one large dose of prednisone and my uveitis resolved and my pain disappeared.

I had recurrent flares of uveitis for the next 20 years. I lost count after more than 30 flares of uveitis. My ophthalmologist and I became good friends because we saw each other frequently. We perfected our routine for putting uveitis back into remission. I didn't tell him about the back pain because it would go away when I took massive doses of prednisone for the uveitis.

I had a huge stockpile of leftover prednisone from the recurrent flares of uveitis. You would be amazed at how many painful conditions prednisone can treat. The worst thing of all was a thing called trigeminal neuralgia. I quit seeing a neurologist and I treated my trigeminal neuralgia myself for 30 years with prednisone. Who needs all those other specialists when you have prednisone available and can self medicate?

PMR happened when I got a bright idea that I would stop taking prednisone because of too many side effects. I decided to throw my entire stockpile of prednisone away. When the generalized body pain occurred, I received the attention of many specialists. The generalized body bain was characteristic of PMR but I'm convinced it was also adrenal insufficiency. My body could no longer regulate inflammation without prednisone. I was dependent on prednisone for 13 years after PMR was diagnosed.

Hi- I have seronegative spondyloarthropathy, meaning I’m not HLA-B27 positive and my inflammatory markers aren’t elevated. Mine is peripheral, not spinal (so far), so it’s not AS.

I’m surprised your primary or rheumatologist didn’t discuss treatment for AS, because untreated, it could lead to other problems (spinal fusion, eye inflammation, breathing issues if your ribcage stiffens) but I could see how PMR would be a priority and maybe even the prednisone would mask or improve the AS symptoms.

As you may have found though, the treatment for spondyloarthropathy is different… It’s usually managed by a biologic, unless you can get enough relief from NSAIDs, but that usually requires higher doses, which aren’t really safe long-term. The symptoms are different too—chronic tendinopathies (the heel pain you described) and inflammatory back pain.

I would think that as your prednisone dose tapers, even if your PMR goes into remission, the AS symptoms may linger or get worse?

Does your rheumatologist treat AS, so could you talk to them about it? I can relate to what you mean about so many specialized providers, but I thought usually general rheumatologists treat PMR and AS, since they tend to me more “common.” That would be frustrating to have to see a different rheumatologist for a separate inflammatory condition.