Prednisone and methetrexate

Me too…

I was diagnosed with PMR 6 weeks ago although symptomatic much longer. I was advised by my primary care not to pursue the prednizone treatment as it may result in needing insulin th manage my type 2 diabetes. My rheumatologist prescribed 15 mg of methotrexate weekly and then increased to 20 mg after 4 weeks. Methotrexate is not a pain medication and only addresses the inflamation at what seemed to be a snails pace. But here is what has happened gradually over 5 weeks. I could not raise my arms over my head. I had great difficulty getting out of bed and up and down from a sitting position. Both hips, shoulders and knees were badly affected. I could barely walk without taking 4000mg of tylenol a day. I gradually realized the pain in my hips disappeared. I can now raise my arms over my head and comb my hair in the morning. I can walk my dog and I can get up and down easily. I do get flare ups usually from over doing and I am limited in the type of swimmingni can do as I still cannot route my shoulders without pain. Now I need to build back my upper body strength. For those that are considering methotrexate to treat PMR keep a hoirnal so you can watch your progress as it is very slow and subtle. I have been fortunate with mild side effects...very mild nausea morning after that is resolved by a couple of crackers, tired for a couple of days and flare ups for a couple of days of joint pain but noticeably less intense and treatment continues. I am down to 2000 mg of tylenol a day. 3rd set of labs in 2 weeks so we will see if my kidneys and liver are still not affected. One thing I have learned is much like the disease the treatment, regardless of type affects everyone differently and I am very fortunate in my outcome so far. I hope this helps anyone that is afraid of using methotrexate for treatment in making their decision.

Sorry for the typos. Should read to keep a journal.

Sorry your going through this. MTX can take up to 12wks or longer to start working . I guess you can attest to that. You have more will power than I did. It took me about 8 wks to diagnose PMR . I thought life was over. Then wait another 12wks for MTX to kick in. The other problem is left untreated many can have symptoms of GCA. I agree though if you can handle it without steroids its probably better. I think for insurance purposes the Dr has to start with MTX. Then you can move to one of the biologics like Kevzara or Actemra that for some work better. But those can be expensive.