I have appointment in 10 days with rheumatologist as I have a high CRP 25, and have sudden onset shoulder, neck and hip and thigh pain. I am very stiff in the morning and have been taking painkillers ibruprofen etc.
If I do not take the painkillers I am so stiff I cannot get out of bed, have difficulty getting out of a chair, and cannot lift my leg to get into the shower. A bath is completely out of the question!!!
My GP does not feel it is PMR as I am 50, have a normal ESR, and it started as neck pain rather than shoulder pain.
I will be asking the rheumy direct if it is PMR and would like a trial of steroids.
So should I stop the painkillers so the rheumy can see how little I can do, or take the tablets?
It's certainly helpful to present yourself in as bad a state as possible! I was 51 with normal bloods - both CRP and ESR butother than that identical to you. Pred was a miracle in 6 hours. However, one GP was like yours and the rheumy wasn't convinced either, wanted it to be anything but PMR despite the result with 15mg pred. Another GP was convinced and we worked from there!
Trouble is - how will you get there without the painkillers? I would definitely try to do so though if you possibly can.
Hi Eileen
Thanks for the reply. I feel they need to see me at my worst! I have been on painkillers for three months now so want a proper diagnosis AND want to stop the painkillers.
Thanks once again.
J
I made sure that I was with no pills whatsoever for 2 days prior to my blood tests. It's a good thing I did, because my inflammatory markers skyrocketed -- which helped convince my GP that I had PMR.
And oh yes, I was in pain. I cold hardly get into and out of a car.
But 12 hours later, relief! Prednisone! Up till that time the GP would not prescribe the prednizone (I was on NSAID's).
Jane, in my experience and that of many others, Ibuprofen did nothing for my PMR pain. However, if it is helping you, then I would remain on it for a little longer - 10 days is a long time to suffer increasing inflammation with worsening pain without any relief.
It's quite possible to have normal ESR and/or CRP with PMR. However, the CRP test is generally considered to be the more reliable marker of the two.
If he's a good rheumy, he should take your symptoms and CRP result seriously and offer you at least a trial dose of steroids. Good luck and do let us know how you get on.
If you're anything like I was in those early months any relief from ibuprofen was very short lived so you only need stop taking them on the day of your appointment.
But putting up with the pain will be worth it - if I could go back in time I would have soldiered on for a bit longer so the rheumatologist could have seen me at my worst. Seeing me at my chirpy best after a couple of months on 15 mg prednisolond has meant two years of questioning the diagnosis and getting nowhere....
Jane, I have experienced all of these pains you describe in the neck, shoulder and lower back/hip area.
I also had the most horrible pain in my right leg when I could hardly make it to the shower like it happened to you. l does look like PMR --- and you are still young, but it can happen with younger people, like Eileen says. I have a friend who was diagnosed with PMR in his fiftyies. He is now close to 80, and still on 5 mg of Prednisone daily. The inflammations burnt itself out in his case after a few years.
I would not be afraid taking Prednisone.....it does make your life livable.
Good luck. I hope your Rheumy will be knowledgeable and can guide you the right way. This forum is very helpful. It feels good talking/writing to fellow sufferers who deal with the same.
Erika
It never ceases to amaze me how doctors of all sorts are terrified of giving a patient a low to moderate dose of pred but will happily leave them on NSAIDs (ibuprofen and co) for months. One lady was told to take ibuprofen for PMR and after 3 doses ended up in hospital with a gastric bleed. OK, she was very unlucky it happened so fast but it can and does happen. There is this assumption that all that can be bought OTC is safe - far from it because there is far less monitoring of patients.
I keep reading that mild PMR can be managed with NSAIDs. Well, I had it mildly for 5 years (i.e. I could still move after the immobile first 2 hours). But I was NEVER not in pain and ibuprofen only took the edge off the worst. The dose I'd have had to take for more than that would have been an overdose.