I've had sudden shoulder, then middle back, then lower back and leg pain since March, 2014 (debilitating within 3 weeks). Doctors did extensive blood work and MRI's to rule out anything else, and then determined that I had "undifferentiated inflammatory arthritis." When I suggested to the doctor that it might be polymyalgia rheumatica, he said "yes it could be, although it's presenting itself a bit differently."
I was in a lot of pain from my neck to my legs -- I couldn't get dressed alone. Doctors put me on prednisone and within 12 hours the pain was gone. 60 mg/day at first, then tapering down to 8.5.
At 8,5 the pain came back and now I'm up to 15 mg a day again.
Here's my concern: when the pain came back it was mainly in my ribcage area -- the stermum, and the backbone behind the sternum. I see stars when I sneeze. I feel confident it's muscle or tendon related because it only hurts when I move -- not when I'm still. Shoulders hurt a bit also, but mainly thoratic region of the spine. With all that I've read, PMA does not apprear in this region.
Even though they've tested me, could something else be going on or can PMA affect the thoratic region of the spine as well as shoulders and hip?
Thanks. This looks like a great support group.
Bob, What is PMA? or did you mean PMR? Even though I am newly dx'd I am still learning about PMR. For me I kept having this vague painful sensation in my right shoulder and in my back. Every time they tested me, my labs came back negative. I knew it wasn't just arthritis but even my awesome PMD attributed it to arthritis and 42+ years of being an RN.
I think lack of collaboration with labs seems to be a common thing with auto immune dx. By the time my labs came back positive, I was in full blown PMR!
Hope this helps you! It's hard getting someone to listen to you!
bedilia, i think he is referring to PMA AS POLYMYALGIA
I know when I was first diagnoised with PMR the Dr poked and prodded and tested my muscle strength and as I still had muscle strength and no pain from the poking and prodding she concluded it was PMR and nothing else as there are many different autoimmune diseases that manifest themselves in a similar way. I do notice that if I keep perfectly still there is no pain at all - but of course we have to move sometime. I don't know about the spine although if you have had a previous injury in the arears of the joints/bones concerned then pain would be there with PMR. I say this from experience only no formal research as I get pain in my shoulders and others I have spoken to with PMR have hip pain from previous artiritis bursas or some such injuries. Eileen may know more from her research as I'm fairly new to this problem and you're right this is a great supportive site.
Thank you Claudia. I am having neuro issues right now and sometimes my brain just stalls! LOL!
If you have associated myofascial pain syndrome you can have pain into the ribcage - and what you describe would fit it. It is caused by trigger points of muscle fibres becoming inflamed and forming hard knots in the affected muscle. Nerves can become trapped or pressured and that can cause referred pain into the relevant area: into the neck and arms if the trigger points are in the shoulders, into the legs if they are in the lower back and into the ribs and back if they are alongside the spine in the mid-back. The pain can be similar to that experienced when a disc is prolapsed.
The trigger points can be dealt with using mobilisation therapy as used in sports massage or by a physiotherapist. Or cortisone injections can be given into the trigger point itself. I also got great relief from Bowen therapy - I can't remember what it is called in the USA.
It often happens alongside PMR - and it is possible that was what started it all off. It is a shame in a way they used such a high dose of pred. The normal PMR starting dose is 15-20mg, 60mg is what is used where GCA is suspected to avoid loss of sight. 60mg would have relieved the myofascial pain syndrome as well and it is only returning now you had got down to a more normal PMR dose. It is likely that 9mg is the "maintenance" dose for you for your PMR for the moment. I repeatedly got stuck at 9mg with a return of pain any lower - until the local pain specialist started to get the more localised bits sorted out (she's an anaesthetist) using the techniques I mentioned. Mine all went haywire starting with sacroiliacitis after tripping but all the muscles in my back were totally solid in spasm. The bit that hurt most was the thoracic area over a long period, then the sacroiliac joint was the weakest point and triggered the rest.
Hi Bob
I was diagnosed in January of this year and the pain that drove me to the doctors was rib cage and mid back pain. It had got to the point where I couldn't breathe in without intense pain. I was also getting pain in my shoulders and upper arms. Luckily the doctor I saw diagnosed PMR immediately and started me on 15mgs of pred. Within two days the chest/back pain had gone. It was an immense relief. The arm/shoulder pain diminished but has never completely gone and is always the first to get worse when I try to reduce my pred dose (no matter how slowly). I have currently reduced to 13.5mg but cant get any lower. Even at this dose the arm pain/fatigue has increased. Sorry, I've digressed from your question! Anyway, I would say that, yes, chest/ribcage area pain can definitely be part of PMR. In your place I would go back up to a dose that eliminates it, wait a while and then try the reduction again. Good luck. Hope you are painfree very soon. Debbie
Bedlilia,
Sorry, I meant PMR. May I did have polymyalgia in mind (PMA).
What a great forum this is.
Eileen,
Thanks for all this. I think they started me on such a high dosage because they were afraid of GCA. My neck and head were bad -- couldn't turn my head a bit. I could not get out of the car. It took me about a minute after standing to be able to walk. The 60 MG /day wiped it out in a day. I could not believe it.
Of ourse, as the dosage has decreased I'm feeling more and more or it.
I'll read every one of these posts and research it all.
Thanks so much
Debbie,
Ah, so you've experience this also. Sorry to hear that but good to know I'm not alone.
I've been forgetting to ask you folks:
When you say you're on 15 MG, 10 MG, etc. do you spread the dosage out during the day or do you take it all at once?
Bob, I stopped my 2mg dose of Prednisone the morning on my PMD's advice. For ME being on Prednisone was a nightmare.
Today is the first day I feel my blood glucose level have stabilized and I'm not shaking all the time! That is how sensitive I am to Prednisone! .As far as the pain goes, it is managable with my Norco. I take it on a routine basis rather than as needed!
As for taking it all at once or dividing the dose, I have always been told it is best to take the whole dose @ around 9-10 am. Taking it this ways allows your adrenal glands to continue to secrete cortisol, which is most active between 3-4am..
Hope this helps
Christine in So. California, USA
I was diagnosed with PMR ast Oct and before I started treatment the pain was awful if I sneezed. I am following a steroid rediction plan from this site. My GP and consultant are not easy to deal with, it pays to be informed as possible. This site is great for support.
This is an interesting debate. the dr surgery i go to (2 of the drs have differing opinions. One said I should take it all in the morning the other split the dose morning and night. I tried the one in morning only and was in too much pain by the next morning so switched to the split dose which I have kept to. It seems to have woked well and I am now down to 8mg split 5 in am and 3mg at night. All reductions are of the night time one however dr suggested when I'm down to zero at night that I split the morning dose. We'll see how I feel at that point and make my decision then. With the slow slow reduction rate it will be a few months before I get to that stage. Will keep you posted. Also I saw a TV program on high fibre diets like 50grs/day. I don't know how you get that much but I have uped my 25gr to about 32grams per day and find the pain of reduction is much better or nearly next to none. Is this coincidence - I don't know - any thoughts anyone