1. < Polymyalgia Rheumatica (PMR)

PMR questions about prednisone, surgery limitations, pain and more

Posted by christi48 @christi48, Nov 25, 2022

I'm relatively new to the PMR scene - diagnosed in June. I'm wondering if anyone has experience with unremitting pain in one or both shoulders. I have heard that people taking Prednisone should inform any health care provider two years after terminating use of Pred. Why is that? I have also read that people taking Pred. should not have surgery. Why? I started tapering my Pred. dose from 5mg to 4 1/2 two weeks ago and have not had any negative reactions so far. How long should I continue that dose before I drop another 1/2 mg.? This group has been immensely helpful and I thank all of you for sharing your knowledge, experience, questions and reactions regarding everything PMR.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

virginiaj | @virginiaj | Nov 27, 2022
In reply to @christi48 "My initial prednisone dosage was 5mg. The doctor prescribed 10 but I always try to get..." + (show)
@christi48

My initial prednisone dosage was 5mg. The doctor prescribed 10 but I always try to get away with the lowest dose possible regardless of the medication. Five mg. banished my daytime pain within a month but I still have pain almost every night in varying degrees especially in my hips. I have found that heat and massage help immensely (I use a massaging seat cushion that lies flat on my bed) and I always feel better once I get up in the morning but for some reason the shoulder pain is almost constant. I also have minor stiffness and I tire easily. I agree that I am doing much better than so many people who have shared their stories and am grateful but always wary. I have found that exercise helps a lot with pain and stiffness and have been adhering to a (mostly) anti-inflammatory diet. I am also lucky to have a stress-free life right now. Thanks to everyone for you input. I always welcome others' stories. I have learned more from this group than any other sources, including doctors.

Jump to this post

Had to laugh when I read your note. My first bout with PMR, I was prescribed 10 mg. Brought the pills home and cut them in half. Dramatic improvement with 5, but had to go to 8 to get it under control. On this, my 3rd bout, the rheumatologist asked if I’d consider 10. I did and it really worked well. Decreased by 1 mg a month until 7, then much slower. Now (almost 3 years later), I’m on 2, heading to 1.5

REPLY
hurtinunit | @hurtinunit | Nov 28, 2022

I just had surgery on my foot two weeks ago and my internist recommended I continue my prednisone before during and after. The anesthesiologist was aware and in agreement. Everything went well!

REPLY
1 reply
loyal | @loyal | Nov 29, 2022
In reply to @hurtinunit "I just had surgery on my foot two weeks ago and my internist recommended I continue..." + (show)
@hurtinunit

I just had surgery on my foot two weeks ago and my internist recommended I continue my prednisone before during and after. The anesthesiologist was aware and in agreement. Everything went well!

Jump to this post

I need a foot surgery- tarsal tunnel. What was your foot surgery? Thanks fir your post.

REPLY
1 reply
hurtinunit | @hurtinunit | Nov 29, 2022
In reply to @loyal "I need a foot surgery- tarsal tunnel. What was your foot surgery? Thanks fir your post." + (show)
@loyal

I need a foot surgery- tarsal tunnel. What was your foot surgery? Thanks fir your post.

Jump to this post

I fell outside my house and broke my foot on the 4th and 5th metatarsals. The surgery was to the 5th which needed a plate to reconnect the bones.

REPLY
awilst | @awilst | Feb 9, 2023

with your immunity compromised (to some degree?) is there any problem with having a dentist, podiatrist (foot dr,) eye dr, do small procedures that require minimal cutting? ( ie podiatrist removing splinter from bottom of foot.) dentist pulling teeth. surgery on eyelid.
small stuff. Is healing compromised by PMR. should you tell dr. you are being treated for PMR, before having procedures?

REPLY
2 replies
DadCue | @dadcue | Feb 9, 2023
In reply to @awilst "with your immunity compromised (to some degree?) is there any problem with having a dentist, podiatrist..." + (show)
@awilst

with your immunity compromised (to some degree?) is there any problem with having a dentist, podiatrist (foot dr,) eye dr, do small procedures that require minimal cutting? ( ie podiatrist removing splinter from bottom of foot.) dentist pulling teeth. surgery on eyelid.
small stuff. Is healing compromised by PMR. should you tell dr. you are being treated for PMR, before having procedures?

Jump to this post

I don't think having PMR is a problem with procedures like this. I was always told that being on prednisone is the problem. Indirectly, I guess PMR is the problem because otherwise you wouldn't be on prednisone.

I have had all of these small procedures done during the time I had PMR. It is always a good idea to tell your medical provider that you take prednsione. I doubt too many podiatrists and dentists know anything about PMR but they will know about prednisone.

REPLY
Mentor
John, Volunteer Mentor | @johnbishop | Feb 9, 2023
In reply to @awilst "with your immunity compromised (to some degree?) is there any problem with having a dentist, podiatrist..." + (show)
@awilst

with your immunity compromised (to some degree?) is there any problem with having a dentist, podiatrist (foot dr,) eye dr, do small procedures that require minimal cutting? ( ie podiatrist removing splinter from bottom of foot.) dentist pulling teeth. surgery on eyelid.
small stuff. Is healing compromised by PMR. should you tell dr. you are being treated for PMR, before having procedures?

Jump to this post

Hi @awilst, My PMR has been in remission during the times I had surgery but I was asked if I was on prednisone or other steroids. You will notice that we moved your post to an existing discussion on the same topic here:
--- PMR questions about prednisone, surgery limitations, pain and more: https://connect.mayoclinic.org/discussion/miscellaneous-questions/.

You might also want to take a look at these related discussions:
--- Not a candidate for elective surgery due to PMR or steroids?: https://connect.mayoclinic.org/discussion/elective-surgery-1/
--- Surgery recovery and PMR: https://connect.mayoclinic.org/discussion/surgery-recovery-and-pmr/
--- Knee Replacement surgery and PMR: https://connect.mayoclinic.org/discussion/knee-replacement-surgery-and-pmr/.

I think I would let them know if my PMR was active and I was on prednisone.

REPLY
redboat | @redboat | Feb 10, 2023

My recent experience: I've been diagnosed with PMR, and started on prednisone a week ago today. I took 10 mg the first two days, then went to 20 mg, after discussion with my doctor.

The pain, while significantly diminished, is still there, and I am still fatigued. I'm grateful for the relief, and hopeful for further improvement, but progress is not as fast as I hoped.

The pain in the 3 weeks before being diagnosed and treated with prednisone, was SEVERE and 24/7. It felt like I had broken bones. I found hot baths were helpful, and ibuprofen did reduce the pain, but still left me very miserable indeed.

My c-reactive protein, which peaked at 34.7 mg/dL is now down to 3 mg/dL (Kaiser says less than 0.5 mg/dL is normal). It seems the prednisone is really helping.

I am 63 years old, with a northern European background, so apparently I am in the genetically predisposed group, although I am male.

Reading other's experiences is very helpful, and comments are welcome.

REPLY
1 reply
Mentor
John, Volunteer Mentor | @johnbishop | Feb 10, 2023
In reply to @redboat "My recent experience: I've been diagnosed with PMR, and started on prednisone a week ago today...." + (show)
@redboat

My recent experience: I've been diagnosed with PMR, and started on prednisone a week ago today. I took 10 mg the first two days, then went to 20 mg, after discussion with my doctor.

The pain, while significantly diminished, is still there, and I am still fatigued. I'm grateful for the relief, and hopeful for further improvement, but progress is not as fast as I hoped.

The pain in the 3 weeks before being diagnosed and treated with prednisone, was SEVERE and 24/7. It felt like I had broken bones. I found hot baths were helpful, and ibuprofen did reduce the pain, but still left me very miserable indeed.

My c-reactive protein, which peaked at 34.7 mg/dL is now down to 3 mg/dL (Kaiser says less than 0.5 mg/dL is normal). It seems the prednisone is really helping.

I am 63 years old, with a northern European background, so apparently I am in the genetically predisposed group, although I am male.

Reading other's experiences is very helpful, and comments are welcome.

Jump to this post

Hi @redboat, Welcome to Connect. You might find the following discussion helpful:
--- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/.

Prednisone is definitely the magic pill to make the PMR pain go away for most of us. One of the problems is that it sometimes takes a higher dose of prednisone to relieve the pain symptoms and their are quite a few conditions that mimic PMR --- Polymyalgia rheumatica: Look before you leap: https://bpac.org.nz/bpj/2013/june/polymyalgia-rheumatica.aspx.

If you are not already doing it, you might want to consider keeping a daily log with your level of pain and dosage of prednisone. The daily log can help you when you are tapering off of prednisone so that you can minimize flare ups.

Has your doctor discussed a tapering plan with prednisone?

REPLY
1 reply
View MoreView Less
Please sign in or register to post a reply.