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Polymyalgia Rheumatica (PMR) | Last Active: Aug 15 6:49am | Replies (16)Comment receiving replies
Replies to "Than you for your insight. My goodness. Bless your heart. I have consulted a pain mgmt..."
I believe that PMR (whatever the heck it is) created an internal environment that enabled the inflammation in my body to run amuck thus contributing to the individual problems I listed. Very technical analysis. Regardless, my Rheumy was willing to treat the pain but not willing to assume the pain had multiple causes. She lumped every pain into the PMR bucket. This is why I went after the pains individually and discovered a host of treatable problems some with solutions and some with long term treatment plans like my osteoarthritis.
Since you are a physical therapist I would think it would be easy for you to identify and describe your pains, thus leading to an accurate diagnosis much more quickly than my process. I self-diagnosed trochanter bursitis but it took me months. I suspect for you it could be as short as 5 minutes. Then it took me 2 years to wind my way to a pain mgmt doctor that has an approach I'm willing to embrace.
I took the approach that this was not just one problem (i.e. PMR) but a series of smaller problems plus PMR. PMR highlighted the problems with a Big Bang thus making it seem like a single problem with a single solution.
@jabrown0407 suggestions have merit. I took Prednisone for more than 12 years. My primary diagnosis was PMR. However, I was diagnosed with other medical problems which included PMR. I had the tendency to wrap it all together into one big inflammatory mess because everything seemed to respond to Prednisone. It was easy to take Prednisone for everything but some of my other problems had better solutions.
I started on a Prednisone dose of 40 mg for everything that included PMR. Some surgical options allowed me to decrease my Prednisone dose. Physical therapy helped so thank-you for being a physical therapist.
The root cause of my PMR was finally addressed after I managed to get to 10 mg after 12 years on Prednisone. My rheumatologist decided that I was "too young" and "too healthy" to take Prednisone for the rest of my life. I thought my rheumologist had me confused with someone else! I think Prednisone was contributing to and causing other medical problems.
When Actemra (tocilizumab) addressed the root cause (elevated IL-6 levels?), I was finally able to taper off prednisone. The IL-6 cytokine has been shown to play a prominent role in the pathogenesis of PMR/GCA. You are correct in wanting to get to the root cause. However, I think the root cause isn't the same for everyone so Actemra might not work for everyone.
PMR stays in remission as long as I do a monthly infusion of Actemra. Some people have "sustained remissions" and are able to discontinue Actemra.
Kevzara is another biologic medication that might address the root cause better than Prednisone for some people.