Working out with PMR

I am a Physical therapist...9 mo history...managing this without prednisone...must take a daily dose of Diclofenac. I take a ton of supplements addressing inflammation, detox, and rebuilding the microbiome. Prior to PMR, I worked out every day in some way...walking 9 or 18 holes of golf, weight lifting, walking several miles, elliptical, bike, or swimming. For a period of time, I had to stop everything. Weaker I became. Slowly I am getting myself back. It is hard to get back the strength I had prior to all of this. I have found the greatest success with lots aerobic on the bike or elliptical for anywhere from 20- 4o minutes. My body likes HEAT....sauna, salt water baths, and steam room. Modified weight lifting is manageable after that on most days. Cannot do the weights I did beforehand. Shoulders are the worse. Squats I do, but it is often difficult to discern if I've made myself the normal muscle sore, or PMR sore. Every day is different. My advice...do not quit exercise. It is the most important part of the healing process, or you will simply get weaker. There is no question this disorder makes you weak....grip, gluts, shoulders, etc...You have to combat that with strength training as much as your body allows. I too have found if I do too much, I will be more painful. As I've gotten better, I can do more and more. Hang in there.

I am just reading your post now. I have been on prednisone 10 mg for 2 weeks and have begun the taper process. I am very interested to know how you knew about diclofenac. Has it been fairly effective in treating your pain levels?
Thank you in advance for your help.

I have been pretty stubborn about not starting on Prednisone. I never knew what PMR was when my PCP gave me Diclofenac, at my suggestion, as I had used it in the past due to knee surgeries. It was 7 mo later that I was diagnosed with PMR. I can absolutely manage with one 125 mg dose daily, in the evenings before I go to bed. Once in a while, I need an extra dose. I am putting up with some amount of pain and/or stiffness every day. I take a ton of supplements, and like most in this forum, watch my diet pretty carefully. I am hoping my body will just correct itself with this intervention strategy. No question, I have had some improvement over the past 2 months since implementing supplements with the Diclofenac. As I have learned in this forum, it takes a long time to get better even with Prednisone. So, I figured, why not try it this way and avoid all the complications of Prednisone. Only time will tell if I am successful.

67 and have been working out pretty consistently for a few years. I had right shoulder rotator cuff surgery in September of 2024 so basically no working out for 4 months afterwards. Started back to the gym everyday for an hour in January of 2025 and got to the point where what I thought was muscle pain and stiffness from workouts wasn't subsiding. After about a week of that I went into one hell of a PMR flare-up. Ease into it and do in moderation is what I found out the hard way.

Be careful and monitor yourself for any symptoms of GCA. I treated myself for PMR with acetaminophen for year without knowing I had PMR, and I eventually developed GCA. I had to be hospitalized for transient vision loss. Fortunately my vision was saved. I've been under treatment for 8 months now, and probably have about another 6 on prednisone and more than that on Actemra.

Tx for the feedback. I am not sure what to expect with GCA. I haven't had any visual problems at all. In fact, before I knee this Dx, I had a Nov ophthalmology appointment...just the usual astigmatism (I don't wear daily glasses)...and new prescription for reading and playing piano. Would an eye surgeon catch something? At some point, I might go with the Prednisone if this condition is not manageable. But the myriad of problems that develop secondary to Prednisone has scared me quite a bit.

Hopefully GCA won't be an issue for you. I keep seeing the statistic that roughly 10-20 percent of people with PMR will develop GCA. There are at least 2 subtypes of GCA. The cranial subtype involves the blood vessels in the head. I had most of the symptoms for this subtype: headache, fatigue in the jaw muscles while chewing, tenderness around the ears and scalp, and pain in the cheekbones. The other subtype is extracranial GCA. I'm not personally familiar with that one, but it affects the large blood vessels outside of the head, like the aorta. I googled it, and it says these are the symptoms:

"May include vague symptoms like fatigue, fever, muscle pain, and sometimes more specific vascular symptoms like arm pain when exercising (claudication), decreased pulses in the arms, or abdominal pain depending on the affected arteries."

I see a rheumatologist and an ophthalmologist on a regular basis. The ophthalmologist can see the damage caused by GCA, and can also monitor for problems caused by prednisone. The rheumatologist can check your pulses to monitor for problems with your large blood vessels.

Having lived with it, I can say GCA is scary too.