i have been diagnosed with PMR and had 4 weeks of 15mg prednisone with great relief. We reduced the dose to 12.5 with good results.. I feel very subtle but noticeable "head symptoms": little, transient pains around head, pressure in left sinus, funny pulsating feeling in temples. Can this be psychosomatic because I am watching out for GCA? I spoke by phone to my rheumatologist who suggested we go back up to 15mgm and see him in a few days for an exam and a decision to do the tabx.
My sed rate went down to normal but my CRP though down, still elevated. I have no other incriminating symptoms. I started out with a significant anemia(I read that a positive indicator against eye problems).
Can anyone relate?
I think you need someone more knowledgeable than me to answer because of the possibility of GCA. I did find that I had headaches nearer the beginning of my diagnosis which appeared to be related to the steroids and which eventually stopped. I did not, however, have anaemia. It was slightly unnerving as I didn't know if it might be a sign of GCA.
About three months into PMR I had very similar symptoms to those you describe. My doctor sent me to an Opthalmologist. He did special tests and looked behind my eyes, but everything was OK. At the time my ESR was over 100 and the CRP very high (can't remember exact figure).
Over the next few months I often had pain along the right side of my head, but never a real headache.
I'm only telling you this because all that was four years ago and I didn't develop GCA. I still occasionally get a quick pain in my temple, but I don't worry about it. If I should suddenly have blurred vision, or jaw claudation I would be up at the hospital within minutes.
I think you will get a lot of answers to this post, but I just wanted you to know that not everyone ends up with GCA.
Good luck!
PS. Sorry 'claudation'' wrong word (don't know where that came from).
Anyway, a locked jaw when chewing.
Just watch for all signs of GCA, I was diagnosed last Feburary with PMR Started off with flu like symptoms, pain in neck and then pain in thighs until I couldn't walk, I was on 20 mg and felt fine until I reduced down to 12.5 mg pred, and developed jaw pain, arteries at side of temple very visible, and pulsation pain at temple area, pain in neck got worse ( which is what I started off with) and then bad headaches,
I was admitted to hospital had biopsy and it was positive, my dose was increased to 60mg pred, was in hospital for 4 days felt fine leaving.
But next day severe headaches a week later I lost sight in right eye for 15 mins had 3 episodes of this, very frightening, doctors say it was tempory, my dose was increased to 80mg , but down to 10mg. But neck pain came back in last 3 months it's not bad and goes as day goes on, but take care
if you have any concerns (other than an emergency, which I think you would recognize), make an appointment to see a good eye doctor. I had my usual headaches and never knew if this one or that one was the onset of GCA. Also had a tender scalp which made me more concerned, but now I put that down to a coincidental change in shampoo brand! Anyway, I went to see my eye doctor, an ophthalmologist, and his thorough examination turned up no signs of GCA, although the ocular pressure is elevated enough to require a return visit in 4 months (glaucoma, pred side effect). This lovely man also told me, without prompting, in the course of the visit all I would need to know about eyes, prednisone and tapering, had I not already become a bit of an expert over the past few months. Quite refreshing attitude on his part, reminded me of my old GP, now retired.
Went back up to 15 of pred and actually feel better. No headache. I was only down to 12.5 about 5 days when the head discomfort began. Seeing my doc Monday in any case. Not sure going down soon is a good idea.
Does anyone go down from 15 mg by 1 mgm at a time instead of 21/2? I have 5mg tabs so breaking them in half seems easiest.
Karen, I developed GCA after a year with PMR remaining undiagnosed, therefore untreated, so that left me at much higher risk of GCA.
It is possible that your head pain was a response to the the withdrawal of steroid following your first reduction. If it was me, I would find a good ophthalmologist and ask them to examine the back of your eyes thoroughly for any changes. However, if you experience any problems with your vision then seek immediate expert advice.
Starting out with anaemia is quite common around the time of diagnosis - it was one of my first symptoms with the undiagnosed PMR, but it righted intself without intervention.
If your return to the 15mg starting dose has resolved the head pain, and if your CRP has further reduced at the time of your next blood test, then you might find it more successful to reduce by just 1mg next time around - less of a shock to the body.
Don't attempt to cut the tablets if they are coated - the coating is designed to protect the stomach. Only uncoated tablets may be cut
I hope you continue to feel better now you're back on 15mg.
Thanks for your input. Having learned that pred and poss. Gca can affect eyes I went for an exam. Everything normal; I have had dry eyes for years and use effective drops for that.
My tablets are the plain, scored prednisone. I am taking a generic ppi I used before. The recent stomach endoscopy show chronic gastritis/esophagitis- this from Naprosyn over many months --- or from PMR?
I think I wasn't on the 15 mg even a month when we reduced. I had an earlier appt. because I had questions.
I would think it is highly likely that the gastric problem was caused by Naproxen. NSAIDs can be hard on the stomach, liver and kidneys. But I can so understand that pre-diagnosis you were desperate to take something for the pain. I took Ibuprofen for 7 months, albeit at a low dose, just to get me off the bed to the loo during my first year with undiagnosed PMR. At the end of that year, I was diagnosed with chronic kidney disease - it could have been from the untreated inflammation but equally it could have been from the Ibuprofen, and I was probably more vulnerable due to only having one kidney.
Have you tried eating a 'live' yoghurt with your breakfast and before taking the steroids - it's a good tummy liner? Also, Manuka honey may help with the esophagitis.
Yes, I eat the yogurt and have no stomach pain now.
I was desperate before my diagnosis and took naproxen to get moving. When I tried to do without it- before my diagnosis , I just cried in pain.
Anhaga,
You have raised an interesting question here is your reply to karenjaninaz. I have been diagnosed with PMR for approx 2.5 years and have been on Prednisone since the DX. I am currently on 6mg daily. I was having vision problems and went to the Eye Dr last week. Much to my surprise I was told that I had high pressure in my eyes and have glaucoma. I asked the cause and the Eye Dr said most likely from the Prednisone. I asked my Rheumy who said that 6mg was not enough of a dose to cause the glaucome. I have another appointment with the Eye Dr in six months. I was wondering if it is common for Prednisone users to develop glaucome. Any comments would be appreciated. Thanks.
I was feeling totally well on 15 mg. and on my last Doctor visit we decided to go down 1 mgm at a time. I emailed for permission to go down 1/2 mg for a few days. I noticed a slight increase in aches but also subtle head "feelings", specifically very transient discomforts, not real pains, at my temples and very transient slight temple pulsations. Other than that I feel really well: good appetite, decent exercise tolerance, no problems chewing or any other pains. but I am paranoid about going down to 14 mgm today. Fortunately I have very good access to my doctor by phone. I wonder if PMR is always accompanied by this temporal stuff to greater or lesser degree. My rheumatologist keeps mention methotrexate as a possible adjunct.
In the past ppi stomach medications always gave me a headache but not the one I am taking: rabaprazole. I also started alendodrate(Fosamax). I also noticed that the joint at the base of both thumbs enlarged almost overnight since this began but no joints hurt at all.
i need to see a blood specialist because one blood protein called: MGUS which means "momoclonal gammopathy of unknown significance". This can be a marker for a blood disorder in the future. Not sure if this is related. I had a battery of ~21 rheumatological tests at a large rheumatology center and those were normal. ❓
My understanding (from the beginning of this journey) is that increased ocular pressure is as common a potential side effect as diabetes, cataracts or bone thinning. Which is why I was surprised when recently browsing through this site to see that it was not listed as a potential side effect of oral steroids, although cataracts are.
When I had my last eye test recently, I was told that the pressure at the back of my eye was raised. I have never had this problem before. At the end of my eye test they repeated this particular test and it had gone down! They did say that the drops can sometimes cause raised pressure hence the repeat test but I think as it hadn't before the only explanation is the steroids.
Karenjaninas - Note that Fosamax is only beneficial in reducing chances of fracture for about three years. After that there is no improvement so you'll probably want to consider discontinuing it at that point. Just something to keep in mind.
Yes, Anhaga, that's just what the rheumatologist told me. All I can do is my TaiChi - I am in a formal school,take my calcium, vit d&k and hope, day by day for progress. I have spinal hardware from scoliosis correction and my back never hurts; I don't want that to start.
I have never been told that I had high pressure either. I do have an eye exam every year so was surprised that this manifest itself over the last one year period. The Eye Dr also told me I had cataracts but I knew those were developing over the last several years. I guess they are at a point that it is time to do something about them. My vision has been cloudy and I have terrible night vision. I am always curious about the side effects of any medication I might have to take but did not make any connection between eye issues and Prednisone or eye issues and PMR for that matter. Thanks.
How much tai chi do you do every day - I am ashamed to say that I'm lucky if I do twenty minutes. 
My pressure must have increased in the 7 months I had been on pred before my last eye exam, as my doctor said my eye pressure reading was always the same before that, so it can happen quickly.