Working out with PMR

I agree with jeff97. After spending months with extreme pain and barely able to function let alone work out I self diagnosed myself with PMR. I took 20mg equiv. of prednisone and the pain was gone in 4 hours. From all my reading 15-20mg is about what the Dr likes to start for treatment. Otherwise they start thinking that maybe this is not PMR and maybe yours is not. Your age will also make the Dr hesitant. GCA diagnosis takes double that dosage. I am familiar that some PMR sufferers have found that a higher starting dose is necessary. If your Dr. is willing to work with you, then maybe try going to 40mg for a 2 or 3 days. The prednisone works on PMR and you should be pain free. Prednisone has a lot of complications so you want to try to taper back as soon as the pain is gone to your lowest possible dose. Within the first 12-14 days you can experiment. After 2 weeks your body shuts off cortisol production and you need to taper more carefully. Once the pain is gone you can start to workout. Be careful since you still have inflammation and are taking drugs to mask it. PMR is not necessarily a life sentence.

Thank you. I have wondered if I have something else because my success with the prednisone hasn’t been great. However my symptoms are textbook. I have no symptoms for GCA. I have only the guidance of my PCP. it’s proven really difficult to get in to see the rheumatologist.

Hi. I’m brand new. I was just diagnosed with. I’m 56. I’ve been a competitive athlete my whole life. I read about people being able to workout. I can barely walk right now and lift my arms. How long will I be in this shape until I can at least lift a little and run? I’m on 20 mg a day. Started with 15, but it took me hours to get going in the morning before. I appreciate any advice.

Hi. I’m brand new. I was just diagnosed with. I’m 56. I’ve been a competitive athlete my whole life. I read about people being able to workout. I can barely walk right now and lift my arms. How long will I be in this shape until I can at least lift a little and run? I’m on 20 mg a day. Started with 15, but it took me hours to get going in the morning before. I appreciate any advice.

I agree with jeff97. After spending months with extreme pain and barely able to function let alone work out I self diagnosed myself with PMR. I took 20mg equiv. of prednisone and the pain was gone in 4 hours. From all my reading 15-20mg is about what the Dr likes to start for treatment. Otherwise they start thinking that maybe this is not PMR and maybe yours is not. Your age will also make the Dr hesitant. GCA diagnosis takes double that dosage. I am familiar that some PMR sufferers have found that a higher starting dose is necessary. If your Dr. is willing to work with you, then maybe try going to 40mg for a 2 or 3 days. The prednisone works on PMR and you should be pain free. Prednisone has a lot of complications so you want to try to taper back as soon as the pain is gone to your lowest possible dose. Within the first 12-14 days you can experiment. After 2 weeks your body shuts off cortisol production and you need to taper more carefully. Once the pain is gone you can start to workout. Be careful since you still have inflammation and are taking drugs to mask it. PMR is not necessarily a life sentence.

Been on prednisone for a couple years. Was down to 2.5. Pain increased significantly. I hate taking Pred, but it works great. Two weeks ago I suggested 20mg to my Rheumatologist to kick it into remission. Pain free now for two weeks. Just waiting now to titrate and hope for the best.

"I hate taking Pred, but it works great."
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In the short term, prednisone works great for the pain caused by the runaway chronic inflammation characteristic of PMR. Unfortunately long term prednisone use to treat PMR has significant drawbacks. The biggest drawback for me was being unable to taper off Prednisone in a timely manner.

The side effects of long term Prednisone use are well documented for RA and other autoimmune disorders. My other autoimmune disorders didn't require me to take prednisone for years. There was no cure for my other autoimmune disorders and long term Prednisone use to prevent relapses is not recommended by the medical specialists who treat them.

I think the belief that PMR will "burn itself out" is a misconception. In many cases that doesn't happen. In approximately half of PMR cases it is characterized by relapses when the Prednisone dose is lowered.

When I finally realized I might be "dependent" on prednisone, I knew something needed to change. I'm no longer dependent on Prednisone to manage my PMR symptoms. The treatment I now receive is costly but something else besides prednisone is needed for relapsing and refractory cases of PMR.
https://www.the-rheumatologist.org/article/how-to-treat-refractory-polymyalgia-rheumatica/#:~:text=Patients%20with%20polymyalgia%20rheumatica%20(PMR,cannot%20tolerate%20a%20glucocorticoid%20taper.

John @johnbishop, Thank you so much for those links! I am learning a lot about PMR through them and through this and other discussion threads. I spoke with my PT yesterday about my confusion regarding what to attribute my soreness to and when to back off or push through exercising, or when to give it a day's rest. Other symptoms for me include morning stiffness, afternoon/evening light headedness and feeling increasingly flushed, foggy and wiped out as the day progresses as well as generalized anxiety (which I attribute to prednisone). I am trying to figure out what is going on. Of my symptoms, what is attributable to the flare? What is over-extending my limits? Am I tapering too fast or too slow? (It sometimes feels like just too much prednisone in my body.)

The PTs response was that we could slow things way down to isolate factors as in a scientific experiment (do everything the same except modulate one factor over time). But the patience that would require and the unintended consequences of say, stopping making any gains in the gym, would extend a person's prednisone duration for months or years and take down our general health and well-being--bringing on a secondary "illness." Avoiding over-use of prednisone is my number one priority. Of course, we're all eager to get out from under prednisone's side-effects.

So I'm trying to clear the fog somehow. Maybe I'm making this harder than it needs to be and am trying to be overly analytical when an easy-going exploratory, intuitive approach may be better. Straddling these ideas, I've decided to add dietary supplements for pain control. I am currently trying PEA (Palmitoylethanolamide) for "Discomfort Relief." I purchased some SPM (a fish oil concentrate that is designed to "target root causes of soreness by supporting the body’s natural ability to soothe and minimize discomfort.") These aren't my ideas--I am working with a naturopathic health practitioner to oversee this. I can't say I'm into meditation, but I am trying to soothe my nervous system in ways that may have some resemblance to meditation.

So I am with you guys. Thankful and really interested in learning from your experiences, all the while recognizing that this is an individualized experience. We each have to find our own way through it.

John @johnbishop, Thank you so much for those links! I am learning a lot about PMR through them and through this and other discussion threads. I spoke with my PT yesterday about my confusion regarding what to attribute my soreness to and when to back off or push through exercising, or when to give it a day's rest. Other symptoms for me include morning stiffness, afternoon/evening light headedness and feeling increasingly flushed, foggy and wiped out as the day progresses as well as generalized anxiety (which I attribute to prednisone). I am trying to figure out what is going on. Of my symptoms, what is attributable to the flare? What is over-extending my limits? Am I tapering too fast or too slow? (It sometimes feels like just too much prednisone in my body.)

The PTs response was that we could slow things way down to isolate factors as in a scientific experiment (do everything the same except modulate one factor over time). But the patience that would require and the unintended consequences of say, stopping making any gains in the gym, would extend a person's prednisone duration for months or years and take down our general health and well-being--bringing on a secondary "illness." Avoiding over-use of prednisone is my number one priority. Of course, we're all eager to get out from under prednisone's side-effects.

So I'm trying to clear the fog somehow. Maybe I'm making this harder than it needs to be and am trying to be overly analytical when an easy-going exploratory, intuitive approach may be better. Straddling these ideas, I've decided to add dietary supplements for pain control. I am currently trying PEA (Palmitoylethanolamide) for "Discomfort Relief." I purchased some SPM (a fish oil concentrate that is designed to "target root causes of soreness by supporting the body’s natural ability to soothe and minimize discomfort.") These aren't my ideas--I am working with a naturopathic health practitioner to oversee this. I can't say I'm into meditation, but I am trying to soothe my nervous system in ways that may have some resemblance to meditation.

So I am with you guys. Thankful and really interested in learning from your experiences, all the while recognizing that this is an individualized experience. We each have to find our own way through it.