Anyone having flareups of PMR after stressful situation?”

Posted by lindaadele @lindaadele, Dec 5 4:01pm

I have had PNR since April 2023. No medication is working great for me! right now I am waiting to see my rheumatologist because I’m in a lot of pain. I have an anxiety disorder so things get me bug quite anxious and I am wondering if this situation can cause flareups of PMR because I feel the immune system goes down when you are very anxious.

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Yes! ... I believe stress --- the immune system --- and inflammation are all interconnected somehow. I haven't figured out how these things interact but I am convinced cortisol levels have something to do with it. Cortisol is called the "stress hormone" for some reason. However, I'm not sure how everything plays out so as to trigger flares of PMR and other autoimmune disorders.

"In summary, through disturbing the balance of immune system, stress induces inflammation peripherally and centrally. This imbalance leads to diversified stress-related diseases. Although there might be various different triggering events, they appear to converge on inflammation."
https://pmc.ncbi.nlm.nih.gov/articles/PMC5476783/
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If anyone understands it all ... I would be interested.

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I had to switch to dexamethasone to get it under control again. Pmr times 4 years. Was on prednisone 5 mg. I am big into 3 times a week pool exercise andchiropractor twice a week. Only answers i have come up with. Always open for ideas

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There is some evidence that inflammation via cytokines affect the brain.
There are also findings of improvements in reduction of cytokine levels
by SSRI anti- anxiety drugs in the medical literature. I have wondered
how chronic occult systemic inflammation affects the nervous system.

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@seniormed

There is some evidence that inflammation via cytokines affect the brain.
There are also findings of improvements in reduction of cytokine levels
by SSRI anti- anxiety drugs in the medical literature. I have wondered
how chronic occult systemic inflammation affects the nervous system.

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My rheumatologist often used the terminology "systemic inflammation" instead of PMR. The association of PMR to GCA makes me believe there is a vascular connection. I like the following definition of systemic inflammation because it talks about a "cascade of chemical reactions" and how WBCs "patrol" while looking for things to attack. In the case of autoimmune disorders, the attack is mistakenly on our own tissues.

"What is systemic inflammation? Systemic inflammation, or full-body inflammation, is the body's response to stress, such as illness or trauma. This process is a cascade of chemical reactions that elicit a response on the cellular level. The white blood cells (WBC) in the body, called leukocytes, patrol the different areas, looking for infection. When they notice signs of trauma, they increase in number and rush to heal the area."

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In addition to PMR, I was a neurology/neurosurgery nurse. I also have trigeminal neuralgia, peripheral neuralgia and severe spinal stenosis. I'm very interested in the nervous system!

The following link is complicated but on the right hand side you can click on whatever interests you. You could also go to the bottom of the list and click on "conclusions."
https://pmc.ncbi.nlm.nih.gov/articles/PMC10419139/#sec11-ijms-24-11902

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"There is some evidence that inflammation via cytokines affect the brain.
There are also findings of improvements in reduction of cytokine levels
by SSRI anti- anxiety drugs in the medical literature. I have wondered
how chronic occult systemic inflammation affects the nervous system."

and

"Yes! ... I believe stress --- the immune system --- and inflammation are all interconnected somehow. I haven't figured out how these things interact but I am convinced cortisol levels have something to do with it. Cortisol is called the "stress hormone" for some reason. However, I'm not sure how everything plays out so as to trigger flares of PMR and other autoimmune disorders."

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I had seen history of abuse or trauma listed as risk factors for diseases in the past. It never made sense to me then but it does now. Stress raises your cortisol level. Your body is trying to fight what is causing the stress but there is no bacteria or virus. It obviously can't fight the external trauma/stressor so it ends of attacking itself. This is my very simplified version that makes sense to me. I don't know if it will pass muster with the docs. 🙂

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@teddyz

"There is some evidence that inflammation via cytokines affect the brain.
There are also findings of improvements in reduction of cytokine levels
by SSRI anti- anxiety drugs in the medical literature. I have wondered
how chronic occult systemic inflammation affects the nervous system."

and

"Yes! ... I believe stress --- the immune system --- and inflammation are all interconnected somehow. I haven't figured out how these things interact but I am convinced cortisol levels have something to do with it. Cortisol is called the "stress hormone" for some reason. However, I'm not sure how everything plays out so as to trigger flares of PMR and other autoimmune disorders."

---------------------------
I had seen history of abuse or trauma listed as risk factors for diseases in the past. It never made sense to me then but it does now. Stress raises your cortisol level. Your body is trying to fight what is causing the stress but there is no bacteria or virus. It obviously can't fight the external trauma/stressor so it ends of attacking itself. This is my very simplified version that makes sense to me. I don't know if it will pass muster with the docs. 🙂

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My PMR was under tolerable control until I had hip replacement surgery on Tuesday which has caused a significant flare up. In addition to the hip pain my body hurts all over especially when I get fatigued which happens with just about any activity. This was not unexpected but the degree of it is a rude reminder of how awful PMR can feel. Hopefully, it will subside once my vitals get closer to normal over time. Best to you all.

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I had a flare of PMR when I flew to see my sister and was exposed to gluten and dairy, which I had eliminated from my diet. Many things can trigger a flare. I try to pay attention to all potential stressors and don’t let them get out of hand. My go-to is gratitude, but I learned that it needs to be practiced. Best to you.

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I am so sorry you are having problems when stressed. I swear by Chamomile Tea. I even have a special cup for it when needed. I did chat with a lovely lady last week who has had PMR for a couple of years, her flare up was after the funeral of her husband and she started drinking alcohol again after giving up for 5 years and was then back to a high dose of Pred. Hopefully she has realised now and can get the PMR under control. We became friends when we were chatting about the film we had seen the night before, she had watched a horror movie and all I could cope with was Shrek as everything else made me feel uneasy. I started to watch the film The Substance and it took me 4 days to finish it as it is so gross. I help people new to working out in the gym and I have learnt to cope with the stress that comes with that. But thinking of being more picky on who I help. When I get home from the gym and I want to scream I just take my dog out and always end up laughing and smiling. Take care x

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@christopherc

My PMR was under tolerable control until I had hip replacement surgery on Tuesday which has caused a significant flare up. In addition to the hip pain my body hurts all over especially when I get fatigued which happens with just about any activity. This was not unexpected but the degree of it is a rude reminder of how awful PMR can feel. Hopefully, it will subside once my vitals get closer to normal over time. Best to you all.

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I contracted PMR soon after my second Pfyzer vaccination (which I believe caused it). It took about a year to taper off of 10 mg. of Prednisone. One of my hips started to be painful during the pandemic and I ended up with a hip replacement towards the end of the pandemic. I recall catching COVID right before the surgery was planned, which made my PMR flareup, after it had been in remission for months. I recovered from my surgery in record time and was grocery shopping within a week! Luckily, I managed to taper off of 2 mg. within a couple of months and have been in remission for a couple of years now, I think.

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@christopherc

My PMR was under tolerable control until I had hip replacement surgery on Tuesday which has caused a significant flare up. In addition to the hip pain my body hurts all over especially when I get fatigued which happens with just about any activity. This was not unexpected but the degree of it is a rude reminder of how awful PMR can feel. Hopefully, it will subside once my vitals get closer to normal over time. Best to you all.

Jump to this post

I have shoulder replacement surgery scheduled for February, and maybe need to rethink it. What dose of prednisone were you on, and how did your surgeon handle it before and during surgery? I have heard some choose to give you a large amount of prednisone via IV drip. I am currently at 8 mg and about to go to 7.5. I am also taking Methotrexate and it has really helped. PMR symptoms are minimal now, but osteoarthritis is severe at times. I don’t want to rock the boat. Let us know how you are doing. I wish you the best, Lisa.

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