I am scheduled for rotator cuff surgery. I have PMR and have been on prednisone for 16 months and am still at 15mg. I am 72 years old and have had 4 back surgeries and I am not able to do very much activity. My rotator cuff pain is only when I sleep on my right side or if I raise my arm above my head. I don't have to do either of those activities, especially if there could be a chance surgery might not heal well or I would have a chance of infection since my immune system is compromised. Does anyone have an opinion on this.
My only experience of surgery is a hip replacement and I don’t know whether the pre op procedures are the same for all surgeries but I was interviewed twice before mine; the first for all the paper work and being told the risks etc. but then I was asked to see the anaesthetist as one of my Pred. reactions was to raise my BP 160/. I was only on 1mg. by then op went ahead no problems and I healed very quickly. Whether your being on 15 would have any significance I don’t know but could you ring the hospital and ask, perhaps? Could you ask to be delayed? I asked for mine to be delayed until the Spring and that didn’t seem to be a problem for anyone.
Of course, the choice is always yours but I can imagine the doubts are hard to live with. Do hope you get some reassurance very soon.
I had my left rotator cuff surgery 7 years ago, prior to the onset of PMR so I’m not a whole lot of help regarding how the recovery goes with PMR. However, I can give a little information that might help you in your decision making.
I’m 100% left handed and had a complete tear of the left rotator cuff tendon.I hurt most of the time and could only do things with that arm that were at chest level or lower so it was an easy decision to have the surgery. Be aware that post-surgery the arm will usually be in a sling and immobile for the first week or two - you can wiggle the fingers. Life is pretty interesting if it’s your dominant arm that’s immobile.
A complete tear requires a larger opening for the surgeon to knit the tendon ends together. Mine was about 3 inches long. It’s my understanding that most surgeries for partial tears are done arthroscopically through 2 or 3 small holes.
The big challenge is recovery. Physical therapy is no joke and is very gradual over a period of months. There were times my therapist had me crying like a little girl and times when I was convinced I’d never have a useful arm again. However, motion and weight exercises do get you there but it takes many months.
Two years later I was “blessed” with a partial tear of the right rotator cuff that sounds similar to yours. Because it was my non-dominant arm I elected to not have the surgery. Over the past 5 years I have experienced improvement in that shoulder to the point that I have minimal pain anymore. It’s not much good for doing anything over my head but that’s what my left arm is for! I’d rate my surgery shoulder at 95% and my non-surgery shoulder at 85%.
It’s a tough decision and I don’t envy you. Personally, regardless of the PMR you need to decide if you will be able to do all the post-surgery therapy needed to have a good shoulder again. Good luck!
Mr. Bella,
I would hesitate to have surgery unless you are VERY uncomfortable with the condition.
I have a torn tendon in my left shoulder and did not option for surgery because it is not painful. The upper movement is limited but I can live with it. I was 72 a at the time.
Now I am receiving Physical Rehab for my right rotary cuff problem with a suspected partial bicep tear. Only certain movements are painful. I am 78 now and still would not choose surgery.
There is an option of ultra sound to find the precise location and a cortisone shot would be helpful.
It is your choice. Good luck!
Thank you very much. You have helped me make my decision. I am not getting surgery.
Thank you. I am not having surgery.
Don’t know where you live, but if you have access to low level light therapy, usually offered through physiotherapists or chiropractors (who have been trained in Ontario, Canada) I recommend it. It is excellent for healing this type of injury. Google light therapy kahn toronto. It’s mostly in Canada but there are now clinics in many other countries offering it. My treatment is covered by our private health insurance as physiotherapy is included in our coverage.
Thank you, I think I will cancel the surgery. I am going to try to live with it like it is.
I live in the US. I will see what I can find, thank you very much.
Hello Mr Bella,
I too have PMR which was just diagnosed about one month ago. My Rheumatologistput me on an initial dose of 20 mg per day of prednisone, which helped immensely with the PMR.
My orthopedic surgeon wants me to get my prednisone dose down to 10 mg before he does surgery. The Rheumatologistput is having me do a 3 month taper to get down to 10 mg. Once there, he will perform the total hip replacement surgery.
The way that I I found out I had PMR is that I need a total left hip replacement. The pre -surgery blood tests (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) showed unusual inflammation in my blood. They did a colonoscopy, an endoscopy, and various other procedures to eliminate other possible issues (cancer, crones, etc.). Finally, they sent me to a Rheumatologistput who poked, prodded, and asked 100 questions. The prednisone knocked down the PMR almost completely within 2 weeks!
For 9 months, when my hip started hurting, I kept getting worse and worse. Almost to the point of needing a wheelchair and caregiver. I thought it was just my body shutting down with severe pain and atrophy from no activity. So it has been a blessing in disguise that they discovered the PMR.
I am so grateful to the people on this site for educating me on PMR! I am getting a more realistic picture of what I am up against.
Sorry for rambling, but this last year has been pure hell, and I am finally getting answers to the mysterious pain I have been enduring, and relief from the pain with prednisone. Hopefully, I will be able to get to a low dose.
Bottom line is that if I get the hip replacement, and keep the PMR under control, I can go back to work in the next 6 months! Pretty good for a 64 year old guy who thought he would be wheelchair bound for the duration.
If you go from 20mg down to 10mg in 3 months, you will probably have a flare and all the pain would return.
I hope Eileen responds to your post. Good luck with your surgery.
Best of luck with the hip surgery. My hip is now five and a half years old and the one bit of my body ( much older than yours ) that never hurts.
If you are offered epidural rather than an ordinary general anaesthetic I can thoroughly recommend. Woke up, ate my supper had a good night’s sleep and home in under 72 hours.
Not necessarily - you have to try it and see what happens. If it fails you need a rethink but it very much depends on what the “final” dose will be. If it is well in single figures then a faster reduction may work. And it is almost certain that the hip pain is feeding the PMR - I know a few people who had hip ops and then were able to reduce to a much lower dose afterwards.
I was in a wheelchair too before my hip op. I was worried silly they might cancel. Hope all goes well with yours. My surgeon wanted my pred reduced too.
Thanks Mr. Bella. I have been made aware of decreasing the prednisone too fast by members here. At this point, I will discuss the rapid decrease with the doctor, and take it from there.
They do have clinics in the US. Somewhere on the website is a list of locations. Make sure it is this kind of light therapy because there are other forms which would be ineffective and a waste of your time and money. I actually was getting it to help with PMR as it has been studied for RA (not PMR) and I’m sure it helped to some extent,at least in helping me get to a low dose without faltering. But I’ve also received it for shoulder problems - not a tear but something wrong with rotator cuff - and it really did help. More recently we are targeting my sciatica and I’m getting better.
Thank you. This may be exactly what I need. I also have severe sciatica pain.
A good physiotherapist, especially ones specialising in sport physio, can be very helpful. Any sciatic pain I have is entirely due to muscle spasm in my low back - sort the muscle spasm, the sciatic pain is sorted.
My physiotherapist has also done some manipulation to release the muscle tension. I believe the light therapy is working to stimulate body’s own healing function. I had problems with both shoulders in sequence. The first shoulder received more sessions of light therapy. When the second one joined the party for some reason I was only able to get a couple of sessions with the light, I think I went on holiday and when I came back I needed therapy for something else. The difference in time it took to heal, and the level of healing, actually turned out to be noticeable. A bit of an inadvertent experiment.
A good physiotherapist will know where the nerves originate in the spine which are contributing to the pain and be able to do things to release the nerves and also give you some exercises to strengthen supporting muscles. A lot of my issues emanate from an arthritic spine.