PMR and Hip, Back Pain

Posted by johnarbaugh @johnarbaugh, Dec 5, 2022

I’m new to this group but not new to PMR. I was diagnosed
May 2020. The past few years have been challenging, to say
the least. Recently my shoulder pain was off the charts, so my
Dr agreed to reboot my prednisone dosage. I went from 5mg daily
up to 20mg daily. Reducing 2.5mg every week. I’m now back down
to 5mg. My shoulder activity has reduced significantly. I barely notice
it anymore. What’s happening now is my lower back and hips are hurting. At first I thought my back was out. I was having trouble walking, and standing up straight. The pain moved from one hip to the
other. Then both hips. It’s not a constant pain like the shoulders, it’s more like very painful muscle spasms.
I’ve seen my primary physician, and had a trip to the ER last week, thinking this was a pulled back issue. Was given muscle relaxers that
did nothing. Now I’m wondering if this new development could be
PMR.
Has anyone had PMR in their hips or lower back? What’s it like?

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

Does seem directly related to the pain. I have been having balance issues since early in my diagnosis and treatment that are worsened by pain but not directly tied into them. Just when my feet are bearing weight only. Not inner ear related. Seen two neurologist and my primary (had MRI) and rheumy, of course. They don't know what to make of it. Very annoying. I can still ride a horse, 'though. That's a plus. Thanks for sharing.

REPLY

John, I just got back from my rheumatologist. His magement must really like him because he spends so little time with his patients. And Heaven forbid if he should smile. Wants me to go down one pill. Currently at 8 mg prednisalone (= 10 mg prednisone). I told him that was too fast. My adrenal gland wouldn't keep up and I would feel terrible. He expressed doubt that my adrenal gland would come into play that soon. I told him about accidentally only taking one pill a couple of months ago and how bad I felt until I realized what had happened. He thought maybe it was my disease not letting me drop down. So we comprimised on one pill (4 mg) and 2 pills the next day. If that doesn't work, then call him. I'm skeptical, but I'll try it and we'll see....

REPLY
@suetex

John, I just got back from my rheumatologist. His magement must really like him because he spends so little time with his patients. And Heaven forbid if he should smile. Wants me to go down one pill. Currently at 8 mg prednisalone (= 10 mg prednisone). I told him that was too fast. My adrenal gland wouldn't keep up and I would feel terrible. He expressed doubt that my adrenal gland would come into play that soon. I told him about accidentally only taking one pill a couple of months ago and how bad I felt until I realized what had happened. He thought maybe it was my disease not letting me drop down. So we comprimised on one pill (4 mg) and 2 pills the next day. If that doesn't work, then call him. I'm skeptical, but I'll try it and we'll see....

Jump to this post

Good for you! Do they make prednisolone in small tablets? My rheumy got me an Rx for 5, 2.5 and 1mg tablets. When things got tough tapering I was taking 1/2 mg doses and cutting the tablets in half.

I would keep a daily log and record your pain level when you get up along with the days dosage if you are not already doing that. Gives you ammo when you talk with the doc and lets you ask some more questions. 🙃

REPLY
@raven1955

I would be very inclined to think that your back/hip pain is related to the PMR. Over the years I've had PMR I've never had flare up pain that showed up in the exact same location. Why does the inflammation move around like that? I don't have a clue but in my experience if I start experiencing unusual pain associated with muscles or near joints I tend to look at my prednisone dose first. Each person is different but prednisone reductions of every 3-4 weeks never worked on me. I might not have a flare up immediately but the inflammation would build up and the pain would greet me once again, usually at a new location. A couple months ago I had gotten down to 3.5 mg of prednisone but started to experience pain in my neck muscles and one shoulder. After a few weeks I finally bit the bullet and jacked the dose up to 10 mg for a five days. That cleared out the inflammation/pain and then I brought my dose back down to 4.5 mg over a couple weeks. The 3.5 dose was likely just a little too low to be effective but it took time for the inflammation to build up to the point of being miserable again. Thankfully I have a rheumy who agrees that I understand how to handle my prednisone and lets me adjust the dose as needed. It's not for everyone, but I use a very slow reduction schedule that has worked for me for the most part. However, it's a constant search for the lowest EFFECTIVE prednisone dose, not a relentless reduction to zero. Here's the link for the "Dead Slow and Nearly Stop" reduction schedule I use, from the Health Unlocked website for anyone that's interested:
https://healthunlocked.com/pmrgcauk/posts/131189593/dead-slow-and-nearly-stop-reduction-plan

Jump to this post

Your post is really helpful to me thanks. I’ve gone from 15mg to 20mg back to 15 mg and I’ve been noticing pain in different areas from where I first had the pain. I still have pain behind my knees if I try to kneel down. Now I also have pain on the insides of my knees which is new and a bit bizarre. I wasn’t sure if it was a flare but you’ve made me realise the inflammation can move around. I guess that’s what it is then. I don’t really want to go back to 20mg- but will see my Rheumatologist in a couple of weeks and discuss. Thanks

REPLY
@suetex

Does seem directly related to the pain. I have been having balance issues since early in my diagnosis and treatment that are worsened by pain but not directly tied into them. Just when my feet are bearing weight only. Not inner ear related. Seen two neurologist and my primary (had MRI) and rheumy, of course. They don't know what to make of it. Very annoying. I can still ride a horse, 'though. That's a plus. Thanks for sharing.

Jump to this post

Physical therapy has helped me with balance issues. Walking every day also helps.

REPLY

Thank you, I agree that PT is helpful. And was using a treadmill faithfuly but now having trouble walking. Definently, not the right direction. Started using a cane, however and that helped take pressure off my trochantor bursitis.

REPLY

Here's a question for anybody. Do you think it is possible to have PMR relapse with only one area of the body affected? Such as you were diagnosed with typical hip and shoulder girdle pain and positive CRP and Sed rate and now your tests are normal, your arms are fine, but you have hip girdle pain and stiffness? Give your opinion. I know what my rheumy thinks.

REPLY
@suetex

Here's a question for anybody. Do you think it is possible to have PMR relapse with only one area of the body affected? Such as you were diagnosed with typical hip and shoulder girdle pain and positive CRP and Sed rate and now your tests are normal, your arms are fine, but you have hip girdle pain and stiffness? Give your opinion. I know what my rheumy thinks.

Jump to this post

Well, yes...🙃, My PMR is in remission but I have sore arms and hips which give me grief at night because I'm a side sleeper and it's tough to get through the night on one side or the other. Mine's partly old age and I'm sure my degenerative arthritis plays a part. I have been wondering if my PMR is coming back but as long as it stays at this level I don't want to go on my happy pills again.

REPLY
@michwest

Your post is really helpful to me thanks. I’ve gone from 15mg to 20mg back to 15 mg and I’ve been noticing pain in different areas from where I first had the pain. I still have pain behind my knees if I try to kneel down. Now I also have pain on the insides of my knees which is new and a bit bizarre. I wasn’t sure if it was a flare but you’ve made me realise the inflammation can move around. I guess that’s what it is then. I don’t really want to go back to 20mg- but will see my Rheumatologist in a couple of weeks and discuss. Thanks

Jump to this post

I too have severe PMR pain on the inside of my knees and goes down to my ankles. Prednisone helps calm the pain but too much of it can weaken your tendons. Also, prednisone can weaken your Achilles tendons, making it harder to walk. There is a fine balance in the treatment between the # of mg/day & PMR. My knees became weak and unstable while on 20 - 15 mg/day. I quit prednisone for a week, exercised a lot and my strength/balance came back-so did the PMR. I restarted with only 5 mg and I am improving. I may have to do 10 mg once or twice a week to find a balance.

REPLY
@suetex

Here's a question for anybody. Do you think it is possible to have PMR relapse with only one area of the body affected? Such as you were diagnosed with typical hip and shoulder girdle pain and positive CRP and Sed rate and now your tests are normal, your arms are fine, but you have hip girdle pain and stiffness? Give your opinion. I know what my rheumy thinks.

Jump to this post

Great question, Suetex and very interesting comments from John and Dallas too. I personally think it's definitely possible to have a relapse and associated pain/stiffness in only one area. I've read a number of times on forums where people didn't catch a flare early because the pain wasn't "typical" and wasn't like their original pain when they were first diagnosed. I've had the side effect of muscle wasting and went from very physically fit to having biceps and leg muscles that are totally out of shape. For me, unlike Dallas, lots of exercise triggered the start of flares. It's such a fine line knowing what's new inflammation that's the start of a flare, or am I too low on my dose or is it arthritis and other players joining the party? I may be totally off base but if I start having muscle pain anywhere that I can't attribute to work, exercise, stretching, etc, then I'm going to figure the PMR is telling me to pay attention because there's inflammation going on.

REPLY
Please sign in or register to post a reply.