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I was very reluctantly diagnosed with PMR a year ago, despite normal ESR and CRP tests. (These are the two they look at to see inflammation-they are NOT specific to PMR; only to inflammation.) if they are not raised, most doctors are skeptical. A rheumatologist refused to see me when my PCP referred me because my markers were not raised. Despite this, I had a classic case of waking up one day with overnight, extreme stiffness and pain in my neck shoulders and hips. My PCP reluctantly prescribed 10 mg of prednisone and I was almost back to normal within 24 hours. Up to 20% of PMR patients do not have elevated markers. If you do some Google research you will find articles that clearly state this. To make a diagnosis in the absence of elevated markers, a course of prednisone is given, and if your body responds to it, the diagnosis should be made. (This is in the medical literature.) I had to arm myself and advocate for myself by doing my own research and taking it to my doctor.
One last thing. I just read an article that said that another pointer to inflammation is high neutrophils/low lymphocytes, so ask about that too. I ALWAYS get copies of my labs, straight from the lab. You can usually sign up for a portal online for easy access, or go pick copies up from the lab.
Best to you. Be your own advocate.
Replies to "I was very reluctantly diagnosed with PMR a year ago, despite normal ESR and CRP tests...."
One always needs to be their own advocate…and responsible for their own welfare …I too find keeping track of my own lab tests helps understand the direction my Dr takes with medications etc..I have no normal marks either but have a very high AST …I’ve had this years before I was diagnosed with PMR and despite many tests have not found the cause of it…anyone else have this peculiarity?
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I was diagnosed with PMR. I started out with 30mg prednisone and felt like a teenager. I had absolutely no pain in my hips/legs or stiffness. Like you, my C-Reactive and Sed Rate was not elevated. When I had my dose reduced to 20 mg, the pain immediately came back. At that point I asked for a referral to a rheumatologist in Rochester/Mayo. He said I had been misdiagnosed and immediately put into action a plan to decrease the prednisone gradually. Unfortunately, the devastating effects of a year on prednisone caused me to h@ve multiple compression fractures and osteoporosis of my entire lumbar spine. Now I am in constant pain.