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Doctors' confusion over diagnosis: Questions they should ask
Polymyalgia Rheumatica (PMR) | Last Active: Jun 2 8:37pm | Replies (39)Comment receiving replies
Dadcue, interested in your thoughts with a true PMR flare. By true flare I mean you have no symptoms of PMR and you are not on medication to treat it. No other medical conditions. I wasnt convinced PMR could restart but I am convinced now that if you get it once your not cured with prednisone merely remission. Steroids being the drug that appears married to PMR I felt a prednisone 5 day pack similar to an asthma attack would be the drug of choice. You mention going from 100-0 hypothetically. My first two flares (if thats what they were) I started at 20mg equiv. prednisone and tapered back over 5 days. No PMR pain and no steroid withdrawal. My third started a week ago and while better with 5 day pack I dont feel like its gone. I will probably experiment with waiting to see what happens. Of course none of this have I seen a Dr. Just basing my diagnosis on the fact that steroids work. What would a flare response look like to you? Or any others opinion.?
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Do you want me to separate out PMR symptoms from everything else? What I remember most was the shoulder pain because it was unlike anything I had ever experienced up until then. Plenty of generalized pain and stiffness so it wasn't shoulder pain only.
Reactive arthritis flares didn't involve shoulder pain. I had pain in other places but never my shoulders. I had many flares of reactive arthritis which I treated with prednisone that was prescribed for uveitis. Most of the time the reactive arthritis flares came with a flare of uveitis so my ophthalmoloist prescribed the prednisone. When I had reactive arthritis pain without uveitis, I self medicated with prednisone leftover from the previous flares of uveitis. I didn't think a rheumatologist was necessary and never saw one.
My prednisone prescriptions were written for uveitis until PMR was diagnosed. My ophthalmologist didn't want me to run out of prednisone whenever I had a flare of uveitis which recurred every year or so. I only needed to take a burst of high dose prednisone for a short period of time. I did these bursts of high dose prednisone followed by a fast taper off prednisone countless times. Uveitis responded quickly and stayed in remission until it flared up again about a year later. Reactive arthritis flares responded in the same way.
With the onset of PMR my prednisone use changed from intermittent use to chronic daily use of prednisone. The shoulder pain didn't go away for a long time. It responded to my daily Prednisone dose but the pain would return the next day.