Associated migratory primarily thoracic back pain

@pjnewm, It sounds like you might have a lot more going on than PMR. There are many conditions that mimic PMR. Have you discussed the back pain with your doctor or rheumatologist?

Yes. I’m an orthopedic surgeon and had MRI of entire spine which was unremarkable. My rheumatologist is unsure because it gets worse with my PMR flare ups. Thanks for your input. I will keep pushing through it.

Are you an orthopedic surgeon?

I had PMR and other problems including spinal stenosis. I'm in need of a lumbar fusion sometime in the future. I noticed an increase in lower back pain whenever I had PMR flare ups.

I don't think chronic inflammation discriminates based on a diagnosis. The inflammatory responses of a deranged immune system can attack anywhere it pleases. The immune system inflammatory responses aren't always logical. I would be inclined to believe you have something more than PMR going on as @johnbishop suggests.

I have inflammatory arthritis in addition to PMR. Damage to my spine was a late finding on an MRI long after I was diagnosed. There was little evidence of inflammatory arthritis at the time and diagnosis. Inflammatory arthritis was suspected based on symptoms and labs but almost no radiographic evidence. I don't know what an MRI or PET scan would have showed when I was diagnosed.

I had advanced degenerative arthritis of my right knee as a result of a meniscectomy when I was a teen. My right knee would hurt whenever I had a PMR flare too.

I had trigeminal neuralgia diagnosed shortly after inflammatory arthritis was diagnosed. Trigeminal neuralgia became a huge problem after PMR was diagnosed. Whenever I had flares of PMR, the electric shocks from trigeminal neuralgia increased to extent that trigeminal neuralgia served as my systemic inflammation alarm.

An extensive work-up was done to find the cause of trigeminal neuralgia. Nothing was found until and MRI "suggested" a problem. The problem the MRI showed was subject to interpretation. The surgeon didn't find what the MRI suggested and how the MRI was interpreted.

Thanks. I am an orthopedic surgeon. No stenosis symptoms, just usually interscapular pain. Probably rhomboid major muscle inflammation. Some DJD at the thoraco-lumbar junction which is usually lower than where I feel most of the pain during my PMR flares.

Welcome to the forum and the PMR/GCA---prednisone world.

I was a neurosurgery nurse for the majority of my career. I find it ironic that I have so many neurosurgery problems. I should be exempt. I've seen good and bad outcomes so I know surgical outcomes can go either way.

Do you do lumbar fusions? I'm really struggling with deciding what to do. One surgeon recommends a multilevel fusion. I was on high dose prednisone when the first surgeon said I was a poor surgical risk.

Another surgeon says just L4-5. I'm on a biologic now to treat PMR but the second surgeon says I need to be off Actemra for approximately a month before and after surgery.

I had both knees replaced about 5 years ago. Now I have heterotopic ossification around both knees - worse on the right. The orthopedic surgeon advises against any surgery in the future. Do you think that includes surgery on my lumbar spine?

I doubt that I would ever agree to the fusion but pain can be a powerful motivator. Pain makes you do things you don't want to do.

Sorry. I’m a shoulder surgeon. No spine

I've had pain off/on for over a year between shoulder blades and into ribs. It flares up sometimes and I have to do about 2 weeks of prednisone (20-25 mg). Once it calms down, I go back on celebrex & turmeric; which manages my pain most of the time. I have many side effects with prednisone, so if I can manage the pain without it, I do. I've had MRI's, x-rays, etc and the doctors could find nothing, so me and Rheumy think just PMR. I've had PMR for around 3 years.

Thanks. Your flares sound very similar to mine, but unfortunately I can’t take NSAI’s because I’m on Plavix

Do you taper off 20 mg. I just started Cymbalta as I’m tapering off prednisone. Going from 25 to 20 mg this week. I will see how that works??