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I’m Not Responding to Prednisone and I Need Advice
Polymyalgia Rheumatica (PMR) | Last Active: Sep 28 9:02am | Replies (83)Comment receiving replies
@paul767 , I think @kereno is correct. Odds are if you have not responded to prednisone it may not be PMR. Other possibilities are maliginancy, infection, hypothyroidism, or connective tissue disorder (Goldman Cecil Medicine).
When prednisone is prescribed for PMR, it alleviates symptoms pretty quickly.
Best to contact your Rheumatologist to advise.
I had PMR, then GCA, undiagnosed for a year so I know some of what you're going through, painwise: pain and disfunction on a scale of 12/10.
All the Best! I hope you can get to the bottom of this with a proper diagnosis and treatment!
Replies to "@paul767 , I think @kereno is correct. Odds are if you have not responded to prednisone..."
@tsc Normally doctors should screen for other issues before providing a diagnosis of PMR. It's quite common for a poor response to steroids to occur because the starting dose of prednisone is too low to quickly reduce the pool of inflammation that has built up in the body., and eliminate the new inflammation produce daily. And some people need higher doses than others. In my own case I was diagnosed with PMR and suspected GCA and needed 100 mg of pred for several days to stop the CRP escalating. And, yes, I was certainly on your 12/10 scale.
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I'm off Prednisone but some pain symptoms that feel like PMR are coming back.
I'm taking Actemra so PMR should be controlled. I have been off Prednisone for nearly 5 years. I'm being evaluated for fibromyalgia. I'm tempted to take a small amount of Prednisone. In theory, prednisone shouldn't help fibromyalgia pain because it isn't supposed to be caused by inflammation. However, taking Prednisone to "rule out" fibromyalgia is inappropriate.
Malignancy, infection, and connective tissue disorders do have inflammation associated with them so they might all respond to Prednisone. All of these conditions might have symptoms similar to PMR.
Hypothyroidism has symptoms similar to PMR but won't respond to Prednisone. In fact, Prednisone might make hypothyroidism worse by suppressing the secretion of thyroid-stimulating hormone (TSH).