Flare

Posted by gingergirl24 @gingergirl24, 6 days ago

I was diagnosed with PMR June 24 and began Prednisone 15mg x1 month. Saw Rheum and began weaning schedule: 12.5mg x 2 weeks, 10mg x 2 weeks and then
decreasing by 1 mg every 2 weeks. I did fine until I got to 3 mg. I developed one sided hip/buttock pain, L thigh pain. The pain has been significant but has me uncertain if this is a flare of my PMG as the sites of my pain are not the same as where they were in my initial diagnosis ( wrist, shoulders, hip all bilateral). I increased my Prednisone to 4mg but increased again to 5 mg after just a few days. Its been a week at 5 mg with minimal improvement. Should I continue or increase Prednisone or assume my pain has another cause? Thanks.

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I had a very acute onset after a stressful travel day and a transatlantic flight.
I couldn’t lift my luggage arriving at ORD and a friend had to assist. Stress and travel?

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@salmountain

I was diagnosed with PMR in the fall of 2023. I was down to 2 mg of prednisone a day and pretty much pain free. I just returned from a trip that involved being on an airplane for 5 hours and have been in pain since returning. Wondering if being confined in the seat on the plane may have caused a flare . Has anyone else experienced the same ?

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I've had similar experience when taking a long drive in the car and suffering for a few days.

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Thank you for responding.
I’m not sure how much to increase my prednisone. Did you bump it up or wait it out ?

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My Rheumatologist would want to know if I had to increase more than 1mg in a month while tapering !! You are tapering pretty fast. It has taken me 14 months to get to 2.5mg. It has been 1mg a month until 2 months ago and now it's half that. My inflammation markers are way down but I still get quite a bit of pain if I push past my daily activity limit.

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@teddyz

Does anyone ever get fatigue without pain? I'm trying to figure out if this fatigue is from a PMR flare or if it's just because work has been too much lately. Or that work has created a flare. Or who knows!

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Yes I get fatigue without pain. I’ve noticed, at least for my own body, I have mostly all good days, but occasionally a not so good day. Something it’s just tiredness and I need to take a breather and maybe do less for the afternoon or the day. It’s a bit unpredictable for me.

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I appreciate everyone's responses. I had appt with my Rheumatologist. He checked my sed rate and CRP. All normal. Also did some XR's to R/O Inflammatory Arthritis, all normal. So, my discomfort probably muscular, not PMR flare. He wasn't worried about me increasing my Prednisone from 3mg to 5mg. He advised me to return to 3mg and continue tapering. So far so good. I have the date for my last dose! Hopefully.
PMR is such a unique experience for all of us. I value everyone's responses and wish you a continued recovery and good health.

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You may need to see someone to determine if the pain is caused by something other than PMR. A rheumy is not going to go thru a process to eliminate non-PMR causes. I had a hysterectomy that solved my hip saddle pain. I had multiple benign tumors that were the source of that problem. I had a pocket of inflammation accumulate in my right shoulder that required aspiration to relieve that pain. The puss was cultured and nothing treatable showed up. They also determined my rotator cuff surgery needed repair, which I may have that surgery in 2025. I have osteo arthritis in both shoulders, injections for that. My bilateral knee pain was identified as osteo arthritis and I now receive hyaluronic acid (gel) injections for that pain. I also had a torn meniscus in one knee and had that surgery earlier this year. I self-diagnosed bilateral trochanter bursitis. I see a pain management doctor for needling treatments for this. Not all pain is PMR pain so please don't make the mistake of assuming it is. I have learned to eliminate other causes for the pain before I credit PMR as the root cause.

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Have not had a long trip since diagnosis, but did have my sx increase before I knew what i had, first occurring after a long holiday car ride (6 hours) last December. I think it is important to get up and move while on long trips, even if walking down the plane aisle. I know that the trip that took me 6 hours last year is going to take longer this year because I am going to stop and walk the rest stops. And take Tylenol routinely during the day, even if I do not have increased pain prompting me. On 2 mg prednisone now with the hopes of decreasing in December but my sx will not allow that now, so continuing with 2 mg. Good luck.

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@seniormed

I had a very acute onset after a stressful travel day and a transatlantic flight.
I couldn’t lift my luggage arriving at ORD and a friend had to assist. Stress and travel?

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No doubt stress will not help

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Has anyone been on Actemra for PMR/GCA? My rheumatologist wants to put me on it for 1 to 2 years. I read the list of possible side effects and it sounds horrendous.

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