Symptoms Concentrated in Legs?

Posted by slf202mcinfo @slf202mcinfo, Mar 20 3:49am

Although my very first symptoms were concentrated in my upper body, neck, shoulders, upper arm my pain and weakness is now in my legs, knees and feet. This seems to be atypical of PMR. Is this anyone else’s experience?

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

My father’s symptoms were concentrated in his legs, core, and shoulders. I didn’t think it was too unusual—my understanding was it usually affects the large muscle groups.

But it’s also possible to have multiple things happening, for example my dad had both shoulder impingement pain and PMR pain, which might explain what you may be feeling. Or pain can be referred.

I hope it gets better for you soon.

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@slf202mcinfo, My first time with PMR seemed to start with some issues with a bad knee which has since been replaced. I don't think it was part of the PMR symptoms but more due to degenerative arthritis in the knee. There are quite a few other conditions that mimic PMR and can be difficult to diagnose but it may be a good question to discuss with your doctor or rheumatologist.

--- Diseases that mimic polymyalgia rheumatica (PMR): https://www.medicalnewstoday.com/articles/diseases-that-mimic-polymyalgia-rheumatica

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I agree with John - recently my sister had a bout of pain, because I have PMR ( and our cousin 10 yrs ago) she already knew what that was .
But she had positive Rh factor AND she has pain in her feet -basically PMR has been ruled out. And her rheumatologist used this term: ENTHESITIS (which i had heard of on THIS site - can't remember who said it )
https://creakyjoints.org/living-with-arthritis/symptoms/what-is-enthesitis/
She will be having an ultrasound soon .

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@nyxygirl

I agree with John - recently my sister had a bout of pain, because I have PMR ( and our cousin 10 yrs ago) she already knew what that was .
But she had positive Rh factor AND she has pain in her feet -basically PMR has been ruled out. And her rheumatologist used this term: ENTHESITIS (which i had heard of on THIS site - can't remember who said it )
https://creakyjoints.org/living-with-arthritis/symptoms/what-is-enthesitis/
She will be having an ultrasound soon .

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Oh no! Glad your sister is getting it checked out. It may have been me—I have an inflammatory arthritis that causes enthesitis (inflammation where the tendons insert into the bones). It’s very painful, but much more localized than I would imagine PMR to be (my dad is the one with PMR).

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My pmr has always been in my legs. It started with me not being able to walk. Hips, upper thighs felt like they were encased in concrete. No upper body issues at all. My rheumatologist kept saying this is atypical and you are not presenting classically. I said buddy I’m as classic as you can get. No sense of humor that guy but he’s been terrific through this. I know of a lot of other people who also have most of their symptoms in the lower body. Not to say there isn’t other stuff going on as well.

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I find this post describes more accurately my experience with what has been diagnosed as PMR. My discomfort and weakness are most dramatic and most disabling in my legs and feet although some upper body also.

I was wondering about enthesitis? I have had both Achilles tendonitis and plantar fasciitis in the past.

Any comments or ideas?

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@slf202mcinfo

I find this post describes more accurately my experience with what has been diagnosed as PMR. My discomfort and weakness are most dramatic and most disabling in my legs and feet although some upper body also.

I was wondering about enthesitis? I have had both Achilles tendonitis and plantar fasciitis in the past.

Any comments or ideas?

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good morning @slf202mcinfo may i ask - have you described your lead up to joining the PMR conversation elsewhere - when did it start ? how long have you been on prednisone - do you still have this pain while on prednisone dose of ...X...mg/day?- meaning- are you having a relapse - have you ever been 100% free of the morning pain and stiffness , which is the 'classic" response in PMR ?

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@nyxygirl

I agree with John - recently my sister had a bout of pain, because I have PMR ( and our cousin 10 yrs ago) she already knew what that was .
But she had positive Rh factor AND she has pain in her feet -basically PMR has been ruled out. And her rheumatologist used this term: ENTHESITIS (which i had heard of on THIS site - can't remember who said it )
https://creakyjoints.org/living-with-arthritis/symptoms/what-is-enthesitis/
She will be having an ultrasound soon .

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I read the updates on this forum when I wake up in the morning before I get out of bed. Today this enthesitis topic hit me right in the face so to speak. I have literally been hobbling around the last three days with heel pain. I had this once before awhile back, went to the foot Dr in my orthopedic group and got diagnosed with Haglund's deformity. I did some PT which helped somewhat. What really helped was wearing open backed clog type shoes. About a month ago I went to this Dr because I could hardly walk, the top of my foot was swollen. I assumed it was from previous OA surgery at the base of my big toe. I opted for a cortisone injection and it got better. This week it's the heel pain. He already told me heel injections are a no-no. So this will be day 4 of limping and my bag of frozen peas on my heel throughout the day. My heel is swollen, has a lump and is red. Walking is very difficult. Enthesitis or Haglund's deformity??
I have been on 3mg pred for weeks now, just started my 6th year of pmr. The last 3 months my crp has been elevated, sed rate is normal. I have tolerable morning pain, stiffness but I am fighting increasing the pred dose. Rheum will tell me to try the mtx again, am not taking mtx. I don't see rheum until May.
I see my pcp on Monday and will be making a list of questions.
I did ger up a little while ago, made chamomile tea and took tylenol.

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@pmrsuzie

I read the updates on this forum when I wake up in the morning before I get out of bed. Today this enthesitis topic hit me right in the face so to speak. I have literally been hobbling around the last three days with heel pain. I had this once before awhile back, went to the foot Dr in my orthopedic group and got diagnosed with Haglund's deformity. I did some PT which helped somewhat. What really helped was wearing open backed clog type shoes. About a month ago I went to this Dr because I could hardly walk, the top of my foot was swollen. I assumed it was from previous OA surgery at the base of my big toe. I opted for a cortisone injection and it got better. This week it's the heel pain. He already told me heel injections are a no-no. So this will be day 4 of limping and my bag of frozen peas on my heel throughout the day. My heel is swollen, has a lump and is red. Walking is very difficult. Enthesitis or Haglund's deformity??
I have been on 3mg pred for weeks now, just started my 6th year of pmr. The last 3 months my crp has been elevated, sed rate is normal. I have tolerable morning pain, stiffness but I am fighting increasing the pred dose. Rheum will tell me to try the mtx again, am not taking mtx. I don't see rheum until May.
I see my pcp on Monday and will be making a list of questions.
I did ger up a little while ago, made chamomile tea and took tylenol.

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Maybe you are another person with multiple problems. There is no rule that says people diagnosed with PMR can't have additional problems. However, most autoimmune problems aren't treated with long term prednisone because more alternatives exist.

Enthesitis is a characteristic of various types of inflammatory arthritis but not PMR. Wait a minute though, that might change.
https://pubmed.ncbi.nlm.nih.gov/27384410/#:~:text=In%20patients%20with%20PMR%2C%20abnormal,addition%20to%20bursitis%20and%20synovitis.
Maybe enthesitis is a characteristic.

I was diagnosed with Reactive Arthritis (ReA) which is a type of inflammatory arthritis. Reactive Arthritis (ReA) isn't the same as Rheumatoid Arthritis (RA). I have problems with my feet as well. My achilles tendon is a target of reactive arthritis. A tendon connected to my thumb "spontaneously ruptured" so I have problems with enthesitis and my tendons in general.

My problem with ReA started when I was much younger so PMR wasn't ever considered as a potential diagnosis. By the time I was "old enough" to have PMR, my previous diagnosis of reactive arthritis caused a great deal of confusion. I was accustomed to taking prednisone to quell my flares of reactive arthritis. When I developed shoulder pain and couldn't lift my arms it was something different for me. My ReA symptoms were mostly restricted to my lower back and legs.

In any case, it took some time for my rheumatologist to sort things out. She eventually concluded I had PMR. I didn't know what PMR was at the time. I thought my diagnosis was being changed so I asked what happened to ReA? My rheumatologist said reactive arthritis didn't go away and she explained that PMR was something else. Then she said it was unfortunate but I had PMR on top of reactive arthritis.

Having more than one autoimmune disorder isn't uncommon. In fact, when a person is diagnosed with one autoimmune disorder they are more likely to develop another one.

"About 25 percent of patients with autoimmune diseases have a tendency to develop additional autoimmune diseases."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150011/#:~:text=About%2025%20percent%20of%20patients,to%20develop%20additional%20autoimmune%20diseases.
Whatever it is, I hope it gets sorted out.

Here is some additional information about enthesitis:
https://www.arthritis-health.com/types/general/what-enthesopathy-and-enthesitis

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