PMR/prednisone/rotator cuff tear

Posted by marmille @marmille, Mar 21, 2025

Good morning,
I have been on prednisone since October and Kevzara January. Currently on 5mg. Have rotator cuff tear right shoulder. Think from prednisone weakens the elasticity of tendons. Anyone else?

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Profile picture for kasandphyl1 @kasandphyl1

I have had or do have a torn muscle in the Gluteus on my right hip. The prednisone has help it and it has been quiet. I was told that they could not fix it. If anything it has helped but who wants to take Prednisone at all? I have had a loss of taste in my mouth since I have been taking Prednisone and it is not enjoyable to eat anymore. Has anybody had this?

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I had a bitter taste in my mouth for several months while taking prednisone. I could eat ok, but that taste bothered me a lot. I could also smell a weird smell in the air around me. Fortunately those side effects have faded as my dose got down below about 10 mg per day

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Yes, I have a full thickness tear of the gluteus medius tendon and a partial thickness tear of the gluteus minimus documented on MRI. It felt like a trochanteric bursitis, common in PMR, but my inflammatory markers were low due to daily prednisone. My physician thinks it is related to the tissue changes with long term prednisone (going on two years of attempting to taper) and he will be stopping that after starting Kevzara which has been approved for me because of the tendon tear.

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Yes. Me too. What is the treatment plan for you?

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Rotator cuff tears can be caused by so many things. I've had both shoulders repaired due to full thickness rotator cuff tears, but mine were due to severe Type 3 acromion and a lifetime of sports that took my arms overhead. Basically my own acromion destroyed my supraspinatus, fun fun!

So many things are multifactorial, none of it is pleasant. I'm sorry you're going through this.

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Profile picture for jeff97 @jeff97

It could be the prednisone, but it could also be the PMR. I had a lot of problems with one shoulder before I was diagnosed with GCA and PMR. The movement of that arm was very restricted and painful. But I've also had problems with muscle strains while tapering prednisone.

Here is response I got in google to the question "Can PMR cause tendon problems":
"Polymyalgia rheumatica (PMR) can cause tendon problems, specifically tenosynovitis, which is inflammation of the tendon sheaths, and may also lead to rotator cuff tendinopathy."

Here is a link to a case report where a rotator cuff cuff rupture was the first symptom of PMR - https://austinpublishinggroup.com/clinical-case-reports/fulltext/ajccr-v3-id1095.php

I was on a high dose of prednisone for the GCA, and my shoulder problems cleared up from that treatment.

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@jeff97
Very interesting. I was recently diagnosed with PMR. Before that I had rotator cuff issues. One torn and one ended up frozen. Also had a arthroscopic knee surgery that end up going poorly. Lots of pain in surgery knee and then the other. I now think this was the PMR coming on until all my joints and body became inflamed. Then blood tests showed off the chart inflammation! I am now on prednisone and feel better but joints are less painful and swelling has reduced. Waiting to see a Rheumatologist to see where we go from here.

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Profile picture for betsyhase @betsyhase

@jeff97
Very interesting. I was recently diagnosed with PMR. Before that I had rotator cuff issues. One torn and one ended up frozen. Also had a arthroscopic knee surgery that end up going poorly. Lots of pain in surgery knee and then the other. I now think this was the PMR coming on until all my joints and body became inflamed. Then blood tests showed off the chart inflammation! I am now on prednisone and feel better but joints are less painful and swelling has reduced. Waiting to see a Rheumatologist to see where we go from here.

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@betsyhase It is interesting. I've seen several times that one of the rules for diagnosing PMR is that it is symmetrical and affects both sides of your body. I had stiffness in both shoulders, but I only had rotator cuff issues on the left. I also had problems in my right knee. I never got a good answer for what was wrong with my knee. It swelled up, and I could only go up and down steps depending on my left leg. Both problems lasted several months, and cleared up instantly once I started taking prednisone. But I was on a high dose of prednisone (60 mg per day) to treat GCA and PMR.

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Profile picture for jeff97 @jeff97

@betsyhase It is interesting. I've seen several times that one of the rules for diagnosing PMR is that it is symmetrical and affects both sides of your body. I had stiffness in both shoulders, but I only had rotator cuff issues on the left. I also had problems in my right knee. I never got a good answer for what was wrong with my knee. It swelled up, and I could only go up and down steps depending on my left leg. Both problems lasted several months, and cleared up instantly once I started taking prednisone. But I was on a high dose of prednisone (60 mg per day) to treat GCA and PMR.

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@jeff97 Thanks for sharing. I am so new to this condition it really helps to hear from others. I am so glad I searched out this site to get information and support.

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Profile picture for betsyhase @betsyhase

@jeff97 Thanks for sharing. I am so new to this condition it really helps to hear from others. I am so glad I searched out this site to get information and support.

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@betsyhase Welcome to the group. It's a big shock when you're diagnosed with PMR or GCA, and a lot to process. There are a lot of helpful people here.

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I am jumping in on this conversation because I have a shoulder problem that imo is most likely related to a rotator cuff issue. I have an upcoming appointment with an ortho Dr..
Raking leaves last fall was when it started. A few weeks ago I was repotting a plant and in trying to twist it to get it out of the pot, I felt a very sharp pain in my upper arm and shoulder. I know it's not pmr. How much prednisone has contributed to compromising tendon functionality I don't know and cannot guess. Range of motion is not good. I've just been avoiding motions that hurt. I'll be finishing hip therapy soon and then start working on the shoulder.
How much do ortho Drs consider pmr and prednisone use in a dIagnosis and does it really matter to them how you got to the painful situation you've developed?
I wonder how much emphasis, other than in rheumatology, pmr and prednisone use actually play in curriculum and continuing education.

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Profile picture for pmrsuzie @pmrsuzie

I am jumping in on this conversation because I have a shoulder problem that imo is most likely related to a rotator cuff issue. I have an upcoming appointment with an ortho Dr..
Raking leaves last fall was when it started. A few weeks ago I was repotting a plant and in trying to twist it to get it out of the pot, I felt a very sharp pain in my upper arm and shoulder. I know it's not pmr. How much prednisone has contributed to compromising tendon functionality I don't know and cannot guess. Range of motion is not good. I've just been avoiding motions that hurt. I'll be finishing hip therapy soon and then start working on the shoulder.
How much do ortho Drs consider pmr and prednisone use in a dIagnosis and does it really matter to them how you got to the painful situation you've developed?
I wonder how much emphasis, other than in rheumatology, pmr and prednisone use actually play in curriculum and continuing education.

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@pmrsuzie
I have a small rotator cuff tear in my right shoulder from 2014 (MRI) and some in my left as well. My PMR started with brutal pain in both shoulders and my upper back that was so bad at night (about 1-2am it'd start) and wake me up with that burning searing PMR pain. The only way to tolerate it was to sit upright on the couch. It still hurt but was not as severe as laying on my back. Couldn't sleep on either side due to R. Cuffs. That went on from Mid-March 2026 until I finally figured it out myself in July. I queried my blood test results and symptoms in Brave and PMR came up with one other disease. PMR fit better than anything else I'd seen all these months. I started 15mg Prednisone the same day I first saw Rheumatologist. I've had to step up 2 times to 25mg because my left shoulder, arm,hand and upper back still get pain. It's not as severe as before Prednisone so it is improving. My Rheumatologist wants to get my shoulder imaged if the 25mg doesn't resolve it all by the end of 2 weeks. I have read in different things online that PMR can manifest in areas of previous injury or damage. In my case, that's true. Had issues with left side of body for years.
Yes, PMR affects both sides to be sure but it seems like some of us can have some areas that are more stubborn to resolve due to underlying issues. I'm not familiar with Prednisone and tendon compromise but definitely have seen that with steroid injections in thumbs etc. I hope you get the help you need and agree it's unfortunate that so few PCPs and other Dr's aren't aware or knowledgeable re PMR and how it can manifest differently for each person. Blessings.

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