Two weeks in, frightened by meds, PMR and COVID Booster Shot
Hi! I’m 59 and WAS perfectly healthy and very active up until 2 months ago. Gosh, am I happy to have found you all. I was diagnosed (sort of) two weeks ago and was started on 25mg of Prednisone which provided great relief but I have many worries about side effects. I’m now down to 10mg and although still in less pain than before the meds, during the nigh the pain gradually returns. I take the meds in the morning and a few hours later I’m better again. Is this normal for PMR? Also, I’ve had 3 COVID vaccines and am due for the next booster but yesterday I happened to stumble upon some research on the correlation between the COVID booster shots and sudden onset PMR. Is this what’s happened to me?? I’m not anti-vax by any stretch of the imagination, just a little (lot) concerned. By the way, I’m seeing an internist next week to confirm diagnosis and discuss the way forward. Any advice, recommendations or help you can provide is welcome.
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I am having issues with connective tissue around my knees so asked my doctor for consideration of an MRI to determine exactly what is going on. I feel stiffness in both knees but no outward signs ( like warmth, redness or swelling). Something is going on but I must admit I was diagnosed with knee bursitis prior to being on the prednisone this July. Now, unfortunately it is worse and I am on 15mg of prednisone day so one would think that would help.
55, active and healthy until PMR hit me overnight in May. Neck one day, shoulders the next and finally hips then wrists. Went from hiking 12 miles on Sunday to not being able to hold a coffee cup or get out of bed without help by Friday. Started 15mg of prednisone on that Monday and was much better in 6 hours and almost 100% within 24 hours. I am lucky that I got into a Rheumatologist one week after symptoms started. She diagnosed PMR after exam and ruling out all other likely possible causes. Dropped to 3mg this week and feel good.
Tips:
-Read this: https://www.rheumatology.org/Portals/0/Files/2015%20PMR%20guidelines.pdf
-Anything that your doctor recommends that goes way outside these guidelines- ask why
-Taper slowly but not too slowly. One example is drop 2.5mg a month until 10mg, then 1mg a month until 5mg and then .5mg every 1-2 weeks until zero.
-Pain is a major indicator or remission. Prednisone is not making PMR go away, just treating the symptoms so if you do not have pain, a quicker taper is fine but pain should be the primary guide.
-Keep a daily log of dose, pain levels, mobility levels, activity levels and any other items of note. Helps to understand and gauge how close you are to remission
-Keep moving. Add activity back slowly and let pain be your guide. I am back to running, hiking 5 miles, lifting, mountain biking and paddle boarding.
-Naps and good sleep are your friends. I now get 7.5-8 hours a night. Needed multi hour naps for the first 5-6 months but do not need them as much now and 30 mins does the trick.
-Read through this and model your daily self assessments off of the PMR-AS which is the PMR activity score.
-PMR-AS is defined in table 1 here: https://ard.bmj.com/content/70/3/447
PMR-AS=CRP (mg/dl)+patient's pain assessment (VAS 0–10)*+physician's global assessment (VAS 0–10)†+(morning stiffness (min)×0.1) + EUL (0–3)
↵* 0=no pain; 10=unbearable pain.
↵† 0=no disease activity; 10= highest possible activity.
↵‡ 0=above shoulder girdle; 1=up to shoulder girdle; 2=below shoulder girdle; 3=none.
CRP, C-reactive protein; EUL, ability to elevate the upper limbs; VAS, visual analogue scale
Good luck!
I am on 15 mg for two weeks, and then it goes to 10 mg for two weeks, and a slow taper after that.
That sounds good!
Thanks for this information. If you have an MRI let me know. I don't want damage to be occurring and nothing done about it. Pain is much better on 4 mgs , but the popping is very annoying.
Same scenario for me! Had the two initial vaccinations and then it hit. My rheumatologist advised me NOT to take any vaccines nor boosters. I am abiding by that. Read up on spike proteins and how they work to impair our immune systems. That might help.
Wow, thank you for this! Your inset was very similar to mine. Within a couple of weeks I went from walking 10km and cycling 65km to not being able to get out out of a chair. I’ll definitely check out the info. So far, on 10mg a day, I’m doing well and preparing to taper down soon. I’ve noticed that the carbs (bread, pasta, beer…) are killers for me. I’ve found alternatives so everything is hunkydory. Good luck to you and again, thank you for the valuable informaion.
Hi- hoping you can advise me. I am a 62 yr old diagnosed with PMR late 12/2021. Started on 15mg of Predisone and by May I was down to 9mg. Then, my brother died tragically and it through me into a flare up and went back to 12mg. Didn’t get into a Rheumatologist until Sept 2022. He ck’d my inflammation markers and the ESR was normal but CRP still elevated. Ran many other test with one returning elevated, positive ANA. He told it keep on Prednisone and to reduce by 1mg a month and see him late November. He started me in Plaquenil 200mg twice a day did asked me to repeat labs in a month. This resulted in high ESR as well as CRP. I did get a flu vaccine the first wk of October which I found to have been when the stiffness was worse about a wk after the injection and my elevated markers were done around the same time. Saw the Rheumatologist and he made no changes to the Prednisone and added oral Methotrexate 10mg every week. I still awake with a PMR pain score if 4-5 and doesn’t subside until 2-3pm. My soreness/pain has always been in my biceps, neck and now upper thighs.
Any advise
@majryan61, Some members have suggested splitting the prednisone daily dosage and taking some in the morning and some later in the day/afternoon to help with the morning stiffness. For both my occurrences of PMR I just took one dose in the morning normally between 6 and 8am before or with breakfast. I kept a daily pain log also and I was normally at 0 or 1 when I first got up in the morning and some light stretching and moving around took care of the early morning stiffness.
I’m beginning to think stress plays a role in flare ups. When my spouse was diagnosed with Lewy Body dementia I had a flare up