Anyone else have PMR with some serious sternum/rib cage pain?

Posted by ksidorov @ksidorov, Jun 3, 2023

Doctor suggests it is Costochondritis which I have read is possible with PMR. The pain is not only in my sternum (like, serious pain when trying to cough or roll over in bed) but now also in my back rib cage area.

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I know exactly what you mean. Some days it feels like a broken rib,🤯 although I’ve no idea what that feels like!! Excruciating, stabbing, aching! Finally diagnosed and put in prednisone a week ago. The pain has since lessened.

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yes, I've been on pred for about 18 months. My PMR first manifested as hip/groin pain. About 6 months ago, the sternum pain showed up (with neck pain as well...) and hasn't gotten any better; if anything, much worse. Pred dosage is now at 2-3 mg/day and am trying to manage pain with OTC analgesics. Also acupuncture. Just wondering if anyone else out there has any other suggestions.

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affirmative for chest area pains, worse if lifting something or trying to hold two sides of something together, Internist has checked out heart and said not the problem and not costochondritis as no particular sore areas along rib/sternum connection areas. Have been off pred for seven months. would like to get back on but MD not agreeing d/t SE of pred. OTC analgesics dont do much, cant take the nsaids d/t gastrointestinal SE. Another rock and a hard place it seems.

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I was just wondering if my “back/rib” pain was PMR or have I maybe fractured vertebrae from my osteoporosis?? Makes me feel not as crazy that someone is experiencing the same pain….sadly I have no answers though. A heating pad does make mine feel better.

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I had costochondritis with PMR. My rheumatologist said it came with the territory I was in. I'm not sure if it was PMR territory or inflammatory arthritis territory. I had both conditions so it might have been a combination of things. It hurt to expand my chest when I took a deep breath.

https://www.webmd.com/pain-management/costochondritis#:~:text=Costochondritis%20can%20sometimes%20be%20a,and%20settle%20in%20your%20chest.
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I have aching pain around the rib cage rather than the sharp pain you describe. Also lots of leg pain. My rheumatologist says these are not from PMR. He's very by the book. Current flare-up causes head to toe pain as though I had a high fever. Does anyone else get this?

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@ksidorov

yes, I've been on pred for about 18 months. My PMR first manifested as hip/groin pain. About 6 months ago, the sternum pain showed up (with neck pain as well...) and hasn't gotten any better; if anything, much worse. Pred dosage is now at 2-3 mg/day and am trying to manage pain with OTC analgesics. Also acupuncture. Just wondering if anyone else out there has any other suggestions.

Jump to this post

Can you explain what original dose of Prednisone you started with or why your Dr., started you on 2-3mg, was that originally as well or a relapse? From what I've seen on Youtube from this rheumatologist in NJ., I gather patients start between 7.5-21mg or a bit higher if the inflammation-Pain doesn't decrease. Also, I assume if 21mg doesn't substantially reduce the Pain within less than a week the diagnosis is not likely PMR. Initially I went on Methyl-Prednisone dose as follows:
Day 1 I took 4mg 6 times for a total dose of 24mg
Day 2 I took 4mg 5 times for a total dose of 20mg
Day 3 I took 4 mg 4 times for a total dose of 16mg
Day 4 I took 4mg 3 times for a total dose of 12mg
Day 5 I took 4mg 2 times for a total dose of 8mg

Methyl-Prednisone is about 20% stronger than Prednisone.

Oddly, I had gone to the hospital on a Wednesday with extreme jaw pain from Urgent care who thought I had Trigeminal Neuralgia. At the emergency room they partially agreed and gave me intravenous Advil and 2 -4 mg doses of morphine then Carbamazepine. Pain wouldn't stop, morphine and all that did nothing. I was using water in my mouth every 2 minutes to stop the pain. That worked... I was to see an Endondonist that Friday for a possible root canal. They sent me home and told it was likely Dental. The day I came home Thursday the pain subsided in the evening. The Endodonist at 9AM the next day found a deeply infected root in a molar that hadn't shown up on normal x-rays, I believe the root died. He felt I need 2 molars pulled, called an Oral surgeon, an hour later I had those 2 pulled, The second tooth showed it was deeply infected and gross on the tip. They took my last wisdom tooth out for fun! lol. The pain I had for 28 hours was like a dentist drilling into a nerve and continuing to drill, mind-boggling. The water treatment worked. Sorry this is so long. Oral surgeon gave me an antibiotic and Prednisone. On Day 3 the PMR that was undiagnosed went away (completely everywhere) but returned by day 5 of the Prednisone. I pre-diagnosed myself (PMR) and 2 Dr.'s agreed. Sometime they back into a PR diagnosis that way my Primary said. I'm on normal Prednisone now 17.5mg buy it isn't quite enough-3weeks into treatment, 1st time diagnosis.

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I definitely had rib pain earlier in the course of my disease. It hurt to take a deep breath. I figured that the muscles and tendons that connect the ribs to each other were affected and as I expanded my rib cage they got stretched. I don't have that pain now, almost 2 years since the onset of PMR. I hope it is a sign that I am improving! I never mentioned it to my rheumatologist because it's not listed as a "typical" symptom. I find that if I report any symptoms that aren't the classic ones my rheumatologist thinks that I'm over the PMR and am just having spine-related or "old age" pains, am just a wimp and need to taper faster!

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@etphnhome

Can you explain what original dose of Prednisone you started with or why your Dr., started you on 2-3mg, was that originally as well or a relapse? From what I've seen on Youtube from this rheumatologist in NJ., I gather patients start between 7.5-21mg or a bit higher if the inflammation-Pain doesn't decrease. Also, I assume if 21mg doesn't substantially reduce the Pain within less than a week the diagnosis is not likely PMR. Initially I went on Methyl-Prednisone dose as follows:
Day 1 I took 4mg 6 times for a total dose of 24mg
Day 2 I took 4mg 5 times for a total dose of 20mg
Day 3 I took 4 mg 4 times for a total dose of 16mg
Day 4 I took 4mg 3 times for a total dose of 12mg
Day 5 I took 4mg 2 times for a total dose of 8mg

Methyl-Prednisone is about 20% stronger than Prednisone.

Oddly, I had gone to the hospital on a Wednesday with extreme jaw pain from Urgent care who thought I had Trigeminal Neuralgia. At the emergency room they partially agreed and gave me intravenous Advil and 2 -4 mg doses of morphine then Carbamazepine. Pain wouldn't stop, morphine and all that did nothing. I was using water in my mouth every 2 minutes to stop the pain. That worked... I was to see an Endondonist that Friday for a possible root canal. They sent me home and told it was likely Dental. The day I came home Thursday the pain subsided in the evening. The Endodonist at 9AM the next day found a deeply infected root in a molar that hadn't shown up on normal x-rays, I believe the root died. He felt I need 2 molars pulled, called an Oral surgeon, an hour later I had those 2 pulled, The second tooth showed it was deeply infected and gross on the tip. They took my last wisdom tooth out for fun! lol. The pain I had for 28 hours was like a dentist drilling into a nerve and continuing to drill, mind-boggling. The water treatment worked. Sorry this is so long. Oral surgeon gave me an antibiotic and Prednisone. On Day 3 the PMR that was undiagnosed went away (completely everywhere) but returned by day 5 of the Prednisone. I pre-diagnosed myself (PMR) and 2 Dr.'s agreed. Sometime they back into a PR diagnosis that way my Primary said. I'm on normal Prednisone now 17.5mg buy it isn't quite enough-3weeks into treatment, 1st time diagnosis.

Jump to this post

Wow, that is quite a journey. I was originally prescribed 20 mg of Pred when it all started (18 months ago). I have self-tapered to the point where it is all manageable with 3 mg (I did try going down to 2 last week - mistake!).
Working with acupuncturist to see if that will help. That, plus exercise and naproxen seems to help.

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So affirming to meet so many others with rib cage pain. I am 2.5 years into this process and currently on 4.5 prednisone. I have had pain in my ribs for 1.5 years. It is slowly improving and directly related to my PMR symptoms. When I have pain in thighs, shoulders or forearms, I have commensurate pain in my ribs. The ribs are sore on inhalation, and when I lay on my back. Very slow to resolve, like the rest of this illness. Good luck with your journey.b

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