Connect
← Return to What is the goal when first diagnosed with PMR?
Discussion
What is the goal when first diagnosed with PMR?
Polymyalgia Rheumatica (PMR) | Last Active: May 25, 2022 | Replies (18)Comment receiving replies
My husband was recently diagnosed with PMR. He was a very active, fit 63 year old mountain biker before the symptoms began. Over a short period of time, we showed all of the classic symptoms of PMR. The GP prescribed prednisone. He took 15mg prednisone for several weeks with little improvement of his pain, stiffness, fatigue and difficulty sleeping. His rheumatologist recommended trying 16mg methylprednisolone/Medrol which is metabolized differently than prednisone. The 16mg dose is roughly equivalent to 20mg of prednisone. The rheumatologist thought it might possibly work better for him. Although he is very slowly seeing his symptoms decrease, he is nowhere near back to normal after taking the methylprednisolone for 11 days.
Has anyone in the Mayo connect community had such a slow response to the corticosteroid treatment? Did you eventually become symptom free so you could begin the weaning process?
We meet with the doc again on Wednesday. She requested a CT of my husband's chest, abdomen, and pelvis to rule out other possible diagnoses.
Thanks in advance for your thoughts.
Replies to "My husband was recently diagnosed with PMR. He was a very active, fit 63 year old..."
Hi @nkdonahue, PMR is supposed to respond to the appropriate dosage of prednisone dramatically. If it doesn 't, the chapter on PMR in Cecil and Goldman's textbook of medicine tells physicians to pursue alternative diagnosis - hypothyrodidm, malignancy, infection or connective tissue disorder. Have the doctors screened you husband for Giant Cell Arteritis, which requires a higher dosage of prednisone? Symptoms are terrible headache, difficulty seeing, scalp tenderness, difficulty chewing and jaw pain, a dry cough? I hope that helps.
Connect
Hi, nkdonohue
Fifteen to 20 mg of prednisone is a common amount to start treating PMR. Actually, success in ridding one of the pain is part of the diagnosis for PMR, as there are no definitive tests for that purpose. Usually, the prednisone gives very fast relief - by which I mean 1, 2, or 3 days. If the steroids don't work, the doctor should keep looking for a different disease. Alternatively, if nsaids or pain killers DO work for him, that is also a clue that it is not PMR.