Is it PMR or muscle soreness from overuse

You have a good idea. It could give you relief after all this time.
If you have no contraindications such as metabolic syndrome or hypertension or chronic infection they could prescribe it. It does not make the diagnosis a certainty as you are aware most inflammatory conditions might improve.
An adequate trial would be 20 mg. Keep advocating for yourself.
If that doesn’t work ask for a rheumatologist for additional testing.

Thank you for your support! At this point I feel confused as to why the muscle aches are not improving and PT says these muscle strains can be slow to heal but in the meantime it is depressing when you go from feeling normal and then soreness and stiffness every day. I hope my doctor will try the prednisone. Good point that it might not lead to a definitive diagnosis. I have read that anywhere from 1%. To 15% of patients do not have elevated inflammatory labs!

My pain started in my right shoulder. Then moved to my left shoulder. PMR then progressed to my legs , knees, hands and hips. I did not have elevated markers. The one place it did not settle was my lower back. This progression of pain happened over about a 3 month period. Prednisone is designed to limit your immune system and reduce inflammation. It can be used on a variety of inflammatory type responses. I agree with seniormed that taking prednisone is not a definitive diagnosis of PMR. You dont mention your age, however legs, knees and hips could be simply over working those muscles. It can take weeks to feel better from any kind of over exertion. If the pain suddenly moves to other places then I might be concerned. Prednisone can be a very difficult drug to manage if your taking it for the wrong reason that makes it even less attractive. Try some muscles relaxers or just about anything to see if they make a difference.

You bring up very good points. I am 62. However the few times I have been given prednisone, for bronchitis flare up, it really wiped me out so I am torn about rushing into taking it. If I had not over exerted myself prior to the hip, hamstring and knee pain I would be very suspicious that I have some inflammatory condition. So far the pain has not migrated other muscles other than some bicep soreness after the PT stretches and they are minimal. Was your pain debilitating? So you could not walk? Or constant and dull? Maybe pain level runs a spectrum of intensity. Thank you for the insights

My pain progressed the same way except I didn't have any Prednisone to take like I usually did for pain. First, one shoulder ached and all day long I carried one arm with the other arm. I felt like I needed a sling for my bad arm. The next day both shoulders ached and I decided two slings wasn't practical and I couldn't put a sling on anyway. I needed help getting out of a chair and wiping was impossible. After about a week I couldn't get out of bed and get dressed without a lot of help.

My only doctor at the time was my ophthalmologist who always prescribed Prednisone for uveitis. I didn't think I needed any other kind of doctor so I listed my ophthalmologist as my primary care doctor. I couldn't call that doctor because I didn't have uveitis. I was angry with myself because I had discarded my entire stash of Prednisone about 2 weeks prior to all of this. I simply decided that I wasn't going to take Prednisone anymore

My wife hated that I took so much Prednisone before PMR was diagnosed. She made an appointment for me to see her primary care doctor without telling me. I wasn't too happy but she was going with me to the appointment so I wouldn't leave out any details.

All I said was that I needed prednisone but that didn't go over well with my wife's primary care doctor. My wife told her the details and they agreed that I needed a rheumatologist. As you have said in the past ... I was busted when I confessed to self medicating with prednisone for years.

I blamed the whole ordeal on not having Prednisone to take. I felt vindicated when the rheumatologist said I would need Prednisone for a year or two. I didn't need to hoard Prednisone anymore but I had no idea what PMR was. I had significantly elevated inflammation markers so at least I didn't have to contend with convincing someone I was in some serious pain.

Yes your pain sounds debilitating and I wonder if that explains why your inflammatory labs were elevated. Higher pain or more widespread pain might cause increase inflammatory lab values? How long ago was your diagnosis? Some people say that aGP can diagnose and manage PMR and others say it is best to see rheumatologist. I think having a rheumatology consult makes sense for me, and I know it will take a while to be seen. Thank you

My take on inflammation markers not being elevated is the following:

It just depends on where the inflammation is. Small amounts of inflammation in the wrong spot can cause a lot of pain. Pain sensors (nociceptors) are not equally distributed throughout the body so pain is not felt equally everywhere.

Another problem is when nerve endings become sensitized to inflammation that is chronic. It doesn't matter if it is a lot of inflammation or not. Think of a sliver that at first you don't even notice. Given time there is a small amount of inflammation and the sliver is all the brain focuses on.

I had a condition called trigeminal neuralgia. The area causing the problem was microscopic. The surgery to relieve that pain was called microvascular decompression (MVD surgery). The pain was horrific but fortunately not all the time. An MRI didn't even reveal the true nature of the problem. Fortunately the neurosurgeon knew where to look and the problem was fixed.

Sometimes trigeminal neuralgia is mistaken for GCA and vice versa but they have distinctly different causes.
https://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/symptoms-causes/syc-20353344#:~:text=Branches%20of%20the%20trigeminal%20nerve,comes%20back%20after%20going%20away.

That makes sense that small amounts of inflammation in the wrong spot can cause a lot of pain.

Wow your comments are so incredibly close to my personal experience it's pretty amazing. So my early signs were exactly as you suggested. I play golf and suddenly started to develop what I thought was sciatica or piriformis syndrome. This started in mid March. So to combat this I upped my gym sessions and stretching routines. Didn't help. Then I took possession of a new house purchase stary of May and it too was a total renovation job. I spent MANY hours either non stop renovating or working and then renovating. I was getting more sore... Hammys, shoulders hips... But I said to myself it was the renovation work and different muscles being used.. Nearly 8 weeks of that finished off by a house move and the pain was at top level. I should have realised it wasn't normal that a regular gym user and person who exercises would be that sore after some different movements.

If your wrists, fingers, ankles and toes are all feeling okay but your hips, shoulders and neck are stiff and painful to extend this is exactly how my symptoms arrived. A blood test showed very high inflammation markers and the doctor prescribed prednisolone for me. Wasn't a miracle drug. Didn't make me feel instantly better like before but definitely allowed me to get up off the sofa or out of bed without major pain or effort.

Hopefully you can get a few tests to help you identify if you too have high inflammation markers as that wouldn't be the case if you just needed more PT work in the gym or had piriformis syndrome. I can definitely testify to that as I already have travelled that same path.

Yes these are the same thoughts I have been having. I plan to ask my doctor to re-run the inflammatory labs. 3 weeks ago they were all normal. Do you have a formal PMR diagnosis? Or did your doctor put you on the prednisone to see if you get relief? I suppose what is most important is getting out of pain, soreness and stiffness. I look forward to getting back to normal! Thanks so much