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Polymyalgia Rheumatica (PMR) | Last Active: Nov 18 7:12pm | Replies (1907)Comment receiving replies
Replies to "My labs were never abnormal. My PCP didn’t think I had PMR bc of this but..."
Someone once explained normal inflammation markers or normal CRP and ESR in the following way:
"It doesn't take too much inflammation in the wrong place to cause a whole lot of pain."
I had a condition called trigeminal neuralgia. This condition has various nicknames but sometimes it earns the honor of of being the worst pain known to humanity.
https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Trigeminal-Neuralgia#:~:text=Trigeminal%20neuralgia%20(TN)%2C%20also,nose%20and%20above%20the%20eye.
I took prednisone for this pain even though I was told repeatedly that prednisone wasn't used for this condition. It always seemed like flares of trigeminal neuralgia happened whenever PMR was active.
What eventually alleviated the pain caused by trigeminal neuralgia was a surgery called microvascular decompression. The problem area needed to be visualized under a microscope to allow surgery to be done.
A CT scan didn't show any abnormalities. An MRI showed "something" but the problem wasn't identified correctly. Fortunately, the MRI was enough for the neurosurgeon to take a look microscopically in order to make an attempt to correct the problem.
Before surgery, the neurosurgeon asked me what I took for the pain. He said people with trigeminal neuralgia usually had a list of pain medications a mile long. When he looked at my medical record he didn't see that I took any pain medication.
I told the surgeon that prednisone was the only pain medication I took for trigeminal neuralgia. I added that nothing else worked very well. The neurosurgeon seemed skeptical so I added that prednisone didn't relieve all of the pain.
The surgery worked. My very first question after surgery was whether or not prednisone actually helped the pain. The surgeon conceded that prednisone was likely helping the microscopic inflammation and swelling that he saw.
It is interesting to note in the above link that GCA is said to mimic trigeminal neuralgia. I'm happy that I was only diagnosed with PMR and not GCA. Trigeminal neuralgia was more than enough pain so I didn't worry about GCA too much. I already had another condition called uveitis which can also result in being blind.
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/uveitis#:~:text=Uveitis%20is%20inflammation%20inside%20your,healthy%20tissue%20in%20your%20eyes.
I eventually learned that I couldn't treat everything with prednisone. That wasn't the best solution in many cases. None of my doctors ever wanted me to take prednisone for as long as I did and certainly not for the rest of my life.
@robin1040 and @linneyshop, There are a couple of other discussions that you might want to take a look at:
--- CRP and SED levels: https://connect.mayoclinic.org/discussion/crp-and-sed-levels/
--- Ongoing pain with normal CRP and ESR - PMR?: https://connect.mayoclinic.org/discussion/ongoing-pain/