What are the benefits and dangers of Prednisone in treating PMR - polymyalgia rheumatica?
Benifit is...It provides a good result very early stage of treatment.
Ill effects are plenty... to name
increased appetite
indigestion
nervousness or restlessness
darkening or lightening of skin color
dizziness or lightheadedness
flushing of face or cheeks
hiccups
increased joint pain (after injection into a joint)
increased sweating
sensation of spinning
Decreased or blurred vision
frequent urination
increased thirst
rarely:
blindness (sudden, when injected in the head or neck area)
burning, numbness, pain, or tingling at or near place of injection
confusion
excitement
false sense of well-being
hallucinations (seeing, hearing, or feeling things that are not there)
mental depression
mistaken feelings of self-importance or being mistreated
mood swings (sudden and wide)
redness, swelling, or other sign of allergy or infection at place of injection
restlessness
skin rash or hives
SO Ur doctor has to decide when to stop it. (
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Is polymyalgia rheumatica considered an autoimmune disease? or autoimmune disorder? Will this put me?
in a wheel chair? will i be crippled? Can I have kids with this kind of disease?
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Polymyalgia Rheumatica (PMR) anyone know anything more about it?
My mother in law has this and has been taking steroids for it but they dont seem to help much, she is so stiff in the mornings that she can hardly move, has anyone else had this condition and how do you cope with it , it has made her very low.
Thanks.
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It is an inflammation disorder that involves pain, stiffness and swelling in the hip and shoulder areas. Like any arthritic condition, until you find out what works for "you" it can be very frustrating and depressing.
I might suggest that your MIL check into non steroid medication though, such as Lyrica or Celebrex.
Steroids are very hard on most people with many side effects.Weight gain, depression, sweating......, if the steroid treatments haven't helped with 10 days, they probably won't.
Of course this is just a suggestion from what I have experienced, I'm not a professional, just another fellow sufferer, trying to help!!
Best Wishes to her, I hope she finds something to help her soon. (
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Anyone with Polymyalgia Rheumatica?
I've just been told that I have Polymyalgia Rheumatica and I'd like to know what to expect from someone that actually has it...I can read the information but I was real life experience.
Thank you.
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There is a Yahoo group called PMRpain that I belong to that has been very helpful. You can go to Yahoo groups and search "pmr" to find it.
I have it and I do not follow the typical protocol and I don't know anybody that really does. I had pains off and on for two or three years and my doctor did not pick up on it. When I changed doctors I got a full blown case of losing weight, severe shoulder, neck and hip pain which radiated down my arms. And legs. I was pretty much a cripple until they gave me 20 mg of Prednisone a day and I got relief almost immediately. I was gradually withdrawn from the Prednisone and took it for about a year. I also take now Methotrexate which helps a little bit but I have not had a bad flare in a few months. Cortisone is a problem as it can raise your blood sugar, thin your bones and drive you crazy. I hope you are not in severe pain right now. I would love it if you could join our mailing list group at Yahoo groups. It is supposed to last only 2 years but mine has been longer. (
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Is there any cure for Polymyalgia Rheumatica. If you have pain across your shoulders all day what can you do?
Is there alternatives to taking steroids
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Steroids are the last resort for this.
Have you tried having a massage with infra-red light?
If applied regularly, 3x a week for about 30 min., it should give you some relieve.
Hope you feel better soon.
*..* (
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Is anyone out there suffering from polymyalgia rheumatica. Are there any help groups that you know of?
Contact Arthritis Care UK for further information. They have a free confidential helpline
http://www.arthritiscare.org.uk/Home (
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Polymyalgia Rheumatica and Prednisolone ?
My mum has this and takes 5mg prednisolone each day.
Her doctor is concerned because her white blood cell count has gone high.
Any ideas ??
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The high white cell count is a common side effect of prednisolone, though 5mg is quite a low dose and if she's been on this dose a long time and this is a new finding, it would be worth considering other causes. The polymyalgia, if it's not well controlled could also cause the high white cell count, but you would expect that your mother would also have worsening of her symptoms and a raised ESR. Steroids can also sometimes mask the symptoms of infections, so your doctor may want to check for these also. The type of white cells and how high the level is would also influence how your doctor might approach this. So this is a fairly complex medical scenario, probably not serious, though impossible to resolve for you online. Hope this helps. (
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Does anyone have polymyalgia rheumatica?
Answer: Polymyalgia rheumatica is a disease that occurs almost exclusively in people over 55 years of age. It is characterized by profound stiffness in the muscles--as opposed to the joints, as in rheumatoid arthritis--and severe muscle pain. Often there is pain in the joints as well. The pain may be accompanied by weakness and fatigue. The onset can be abrupt or it can creep up slowly over a few weeks. Usually within those few weeks, the patient suffers immensely from this condition.
The diagnosis of polymyalgia rheumatica is made on the basis of the above symptoms plus a very elevated sedimentation rate. The sed rate of the blood is a measure of the total inflammation in the body, and with polymyalgia it often goes to very high levels.
The cause of polymyalgia is unknown in conventional medicine. It is treated with high doses of the anti-inflammatory, adrenal hormone prednisone. As our questioner points out, the relief with prednisone is very quick, often within hours, and patients are usually grateful for this seemingly miraculous treatment. The difficulty with prednisone, of course, is not getting on it, but getting off it. Taking prednisone for prolonged periods of time, including the time needed to treat polymyalgia, will suppress the adrenal glands so much that it makes it very difficult to come off these medications. I've seen it take two years or more to successfully wean a patient off prednisone. During that time the well-known side effects of prednisone come into play. These include diabetes, cataracts, stomach ulcer, and many more. Clearly, another approach to this illness is needed.
Whenever a steroid drug like prednisone makes a condition better, at least temporarily, we can conclude that a basic cause of the condition is poor adrenal function. Therefore, it is helpful to incorporate dietary changes that support the adrenal gland. First and foremost is the elimination foods that stress the adrenal glands, like sugar, caffeine and nicotine. Then we must provide the raw materials with which the adrenal gland makes its many hormones. These are chiefly cholesterol, vitamin C, vitamin B6 and vitamin A. Raw milk products provide vitamins C and B6, and cod liver oil and butter from grass-fed cows provide vitamin A. Third, we can support the adrenal glands with adaptogenic herbs. These contain certain saponins that the body can turn into cortisone-like substances--they are called "adaptogenic" because they help the body adapt to stress. The two I use in my practice are ginseng and licorice.
This type of adrenal support can help the condition of polymyalgia rheumatica, but rarely does it completely relieve this illness. They do help--the pain is lessened--but the much-needed remission does not occur.
Recently, I have used a cleansing program to treat polymyalgia with very positive results. Various fasting or cleansing approaches have long been used for autoimmune and rheumatological diseases (such as polymyalgia) and no one is certain why they help, but that they do help is quite clear. In fact, this month's issue of Alternative Therapies reports on six patients with a variety of serious autoimmune and rheumatological diseases, all of whom went into remission after a 2-3 week water fast.
Interestingly, the patients stay in remission, often for many months after the fast is completed, as though some change occurs in their organ function which lasts even after the fast is completed. I have found the same thing in my practice.
The two programs I have used are not so much fasting programs as they are cleansing programs. The difference being that in cleansing programs, the person takes in enough nutrients, fats and proteins to enable him or her to carry out an almost normal life during the fast. One such program is the Milk Cure described in the Summer 2002 issue of Wise Traditions. Another is a cleansing program from Standard Process. Through the Milk Cure, or through the herbs and powder of the Standard Process program, the patient can remain nourished, but the limited food intake allows the digestive system to rest, and the body to turn its attention to addressing other imbalances.
The main component of the Standard Process cleansing program is a powder that contains a small amount of whey protein and a lot of herbal extracts, plus flax seed meal. The powder is mixed with olive oil and taken several times per day. A supplement containing liver and detoxifying herbs is also given as well as a green food extract or wheat grass. During the fast, the patient can also eat raw fruits and vegetables and drink water. After the three-week fast, I recommend a transition diet of bone broth, raw butter, cooked vegetables and fruit, soaked grains, and sprouted seeds and nuts. This fast should only be carried out under the supervision of a qualified practitioner who is familiar with Standard Process products.
I have had dramatic results using the Standard Process program. Used for polymyalgia, the pain and stiffness begin to recede and then disappear completely. I have also had excellent results with psoriasis and rheumatoid arthritis. (
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What is Polymyalgia Rheumatico and how is it treated? What are the symptoms?
I am interested in the disease condition called polymyalgia Rheumatica, what are the signs and symptoms and how the condition is treated. Where is the pain located? - back, legs, arms, neck, where? How long does this condition usually last? Is exertion and/or exercise good or bad when one has this condition?
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Like most people, you've probably experienced stiff and sore muscles occasionally — maybe after a strenuous hike or a weekend of yardwork. Now imagine feeling that way all of the time. That's what it's like to live with polymyalgia rheumatica (PMR), an inflammatory disorder that causes widespread muscle aching and stiffness, primarily in your neck, shoulders, upper arms, thighs and hips.
Although some people develop these symptoms gradually, polymyalgia rheumatica can literally appear overnight. People with polymyalgia rheumatica may go to bed feeling fine, only to awaken with stiffness and pain the next morning.
Just what triggers polymyalgia rheumatica isn't known, but the cause may be a problem with the immune system, perhaps involving both genetic and environmental factors. Aging also appears to play a role — polymyalgia rheumatica almost always develops in people age 50 and older.
Polymyalgia rheumatica usually goes away on its own in a year or two — often as mysteriously as it came. But you don't have to endure the pain and disabling effects of polymyalgia rheumatica for months or years. Medications and self-care measures can improve your symptoms.
Signs and symptoms
Polymyalgia rheumatica causes moderate to severe aching and stiffness in the muscles in your hips, thighs, shoulders, upper arms and neck. Initially, you may have pain on just one side of your body, but as the disease progresses, symptoms are likely to occur on both sides.
Stiffness is usually worse in the morning or after sitting or lying down for long periods. At times, the discomfort also may be severe enough to wake you at night.
The aching and stiffness of polymyalgia rheumatica often occur suddenly, but sometimes may develop gradually. Polymyalgia rheumatica can cause other signs and symptoms including:
Fatigue
Unintentional weight loss
Weakness or a general feeling of being unwell
Sometimes, a slight fever
Anemia (low red blood cell count)
In the United States, approximately 15 percent of people with polymyalgia rheumatica have a related condition called giant cell arteritis, which causes the arteries in your temples and sometimes in your neck and arms to become swollen and inflamed.
Causes
Polymyalgia rheumatica is an arthritic syndrome that causes your muscles to feel achy and stiff due to mild inflammation in your joints and surrounding tissues. Most of the inflammation occurs in the hip and shoulder joints, but it may develop elsewhere in your body as well. In general, the inflammation isn't as severe as that in inflammatory types of arthritis, such as rheumatoid arthritis.
In polymyalgia rheumatica, inflammation occurs when white blood cells — which normally protect your body from invading viruses and bacteria — attack the lining of your joints (synovium). Researchers aren't sure what causes this abnormal immune system response, but they suspect that as with many disorders, both genetic and environmental factors are involved.
There may be a link between polymyalgia rheumatica and certain viruses, such as adenovirus, which causes respiratory infections ranging from the common cold to pneumonia; human parvovirus B19, the source of an infection that primarily affects children; and human parainfluenza virus
Risk factors
Although the exact causes of polymyalgia rheumatica are unknown, certain factors may increase your risk of developing the disease, including:
Age. Polymyalgia rheumatica affects older adults almost exclusively — the average age at onset of the disease is 70.
Sex. Women are two times as likely to develop the condition as men are.
Race. Although polymyalgia rheumatica can affect people of any race, the vast majority are white. People of Northern European and Scandinavian origin are particularly at risk.
Giant cell arteritis. Also at risk are people with giant cell arteritis, a condition that causes arteries in your temples or sometimes other parts of your body to become swollen and inflamed. As many as half of people with giant cell arteritis also have polymyalgia rheumatica.
When to seek medical advice
See your doctor if you suspect you have polymyalgia rheumatica. Some people delay getting medical care because they think it's normal to have aching and stiffness as they grow older. But persistent pain is never normal. And because doctors can successfully treat polymyalgia rheumatica, you can be spared months or even years of unnecessary discomfort and disability.
Screening and diagnosis
The signs and symptoms of polymyalgia rheumatica are similar to those of a number of other conditions, including rheumatoid arthritis and polymyositis — a disease that causes muscle inflammation and weakness. For that reason, your doctor will diagnose polymyalgia rheumatica only after ruling out other possible causes for your pain and stiffness.
To aid in the diagnosis, your doctor will interview you about your medical history and current symptoms and conduct a thorough physical exam. You're also likely to have one or more tests, including:
Sed rate. If your doctor suspects polymyalgia rheumatica, he or she will order a blood test that checks your erythrocyte sedimentation rate, commonly known as the sed rate. This test measures how quickly your red blood cells settle when placed in a test tube. Generally, the blood cells fall faster — that is, the sed rate increases — when inflammation is present. But because many conditions can cause inflammation in your body, including infections and chronic diseases, such as arthritis and other rheumatic disorders, an elevated sed rate alone can't confirm the presence of polymyalgia rheumatica.
Rheumatoid factor (RF). RF is an antibody — a protein made by the immune system — that's often present in the blood of people with rheumatoid arthritis, but not in the blood of people with polymyalgia rheumatica. For that reason, this test can help your doctor distinguish between the two conditions.
Other blood tests. Your doctor may also check the number of red blood cells and platelets (thrombocytes) in your blood. Platelets are colorless blood cells that help stop blood loss when you're injured. Most people with polymyalgia rheumatica have an unusually high number of these cells (thrombocytosis). On the other hand, many people with polymyalgia rheumatica have a lower number of red blood cells than normal and are often anemic.
You may also have a simple and inexpensive blood test that checks levels of C-reactive protein in your blood. The protein is produced by your liver as part of a normal immune system response to injury or infection. Among other things, high blood levels of C-reactive protein may indicate the presence of inflammation.
Checking for giant cell arteritis
If you receive a diagnosis of polymyalgia rheumatica, your doctor will check for a related condition called giant cell arteritis, which occurs in some people with polymyalgia rheumatica. Signs and symptoms such as new headaches, a tender scalp and pain when you chew, along with the results of a sed rate test can help determine whether you have this disorder.
The only way to confirm a diagnosis of giant cell arteritis is by taking a small sample (biopsy) from the scalp artery in your temple (temporal artery). The sample is then examined under a microscope in a laboratory. Because polymyalgia rheumatica and giant cell arteritis are both treated with corticosteroids, your doctor may simply suggest beginning treatment, rather than perform a biopsy.
Complications
The most serious complication of polymyalgia rheumatica is giant cell arteritis. The exact relationship between the two conditions isn't clear, but up to 15 percent of people with polymyalgia rheumatica also develop giant cell arteritis and nearly half of those with giant cell arteritis have polymyalgia rheumatica.
Giant cell arteritis causes the lining of arteries to become inflamed and swollen. Arteries are blood vessels that carry oxygen-rich blood from your heart to the rest of your body. Although giant cell arteritis can affect the arteries in your neck, upper body and arms, it occurs most often in the scalp arteries in your temples. Untreated, giant cell arteritis may lead to vision loss, a stroke or an aortic aneurysm, a potentially life-threatening bulge in the large artery that runs down the center of your chest and abdomen.
Polymyalgia rheumatica itself causes few other serious problems, but the corticosteroid drugs used to treat the disease can cause a number of serious side effects, such as weight gain, high blood pressure, osteoporosis, high blood sugar levels and cataracts.
Treatment
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Advil, Motrin, others) can be effective in treating mild symptoms of polymyalgia rheumatica, although long-term use can cause stomach and intestinal bleeding, fluid retention, high blood pressure, renal insufficiency, worsening congestive heart failure, liver function test abnormalities, and possible cognitive changes.
Corticosteroids
For more severe cases, the usual treatment for polymyalgia rheumatica is a low, daily dose of an oral corticosteroid drug such as prednisone. Relief should be almost immediate. If you're not feeling better in a few days, it's likely you don't have polymyalgia rheumatica. In fact, your response to medication is one way your doctor may confirm the diagnosis.
After the first month, when your sed rate and platelet count have normalized, and any anemia is improved, your doctor will gradually start lowering the amount of cortisone you take until you reach the lowest possible dosage needed to control inflammation. Some of your symptoms may return during this tapering-off period.
The amount of time on medication varies from person to person. Most people are able to discontinue steroids within two years. Don't stop taking this medication on your own, however. Because corticosteroids suppress your body's natural production of cortisone, stopping suddenly can make you very ill.
At the same time, taking steroids, even in low doses, for long periods can lead to a number of side effects. This is especially true for older adults — those most likely to be treated for polymyalgia rheumatica. That's because they're more prone to develop certain conditions that also may be caused by corticosteroids, such as:
Osteoporosis. This condition causes bones to become so weak and brittle that even slight movements such as bending over, lifting a vacuum cleaner or coughing can cause a fracture. Older women are most at risk of osteoporosis, and taking steroid medications increases the risk. For this reason, your doctor is likely to monitor your bone density and may prescribe calcium and vitamin D supplements or other medications to help prevent bone loss.
High blood pressure (hypertension). Long-term corticosteroid use can also raise blood pressure. For that reason, your doctor is likely to monitor your blood pressure and may recommend an exercise program, diet changes and sometimes medication to keep blood pressure within a normal range.
Cataracts. Cortisone increases your risk of cataracts, a condition that causes the lens of the eye to become cloudy, impairing vision.
Other possible side effects of cortisone therapy include weight gain, decreased immune system function — making you more prone to infections — muscle weakness and high blood sugar levels, which may increase your risk of diabetes or worsen diabetes you already have.
Because of these risks, researchers are investigating other medications to treat polymyalgia rheumatica. Researchers have reported some success with a combination of the drug methotrexate and corticosteroids. People on this combination were able to stop taking steroids sooner.
Self-care
Once you start taking medication for polymyalgia rheumatica, your pain and stiffness should greatly improve. But the suggestions below also can help:
Exercise regularly. Exercise can reduce the pain of polymyalgia rheumatica and improve your overall sense of well-being. It can also help prevent weight gain, a common side effect of taking corticosteroids. Emphasize low-impact exercises such as swimming, walking and riding a stationary bicycle. Moderate stretching also is important for keeping your muscles and joints flexible.
If you're not used to exercising, start out slowly and build up gradually, aiming for at least 30 minutes on most days. Your doctor can help you plan an exercise program that's right for you.
Eat a healthy diet. Eating well can help prevent potential problems such as thinning bones, high blood pressure and diabetes. Good nutrition can also support your immune system. Emphasize fresh fruits and vegetables, whole grains, and lean meats and fish, while limiting salt, sugar and alcohol.
Get adequate amounts of bone-building nutrients — calcium and vitamin D. If you find it hard to get calcium from your diet because you can't eat dairy products, for example, try calcium supplements.
Pace yourself. Try to alternate strenuous or repetitive tasks with easier ones to prevent straining painful muscles. Use luggage and grocery carts, reaching aids, and shower grab bars to help make daily tasks easier. (
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Polymyalgia rheumatica at age 35? How would CRP test need to be?
Is is possible to get polymyalgia rheumatica at age 35? My Dad had it in his 60s, some sites say patients are always over 50 (but some suggest it is possible but rare at ages under 50).
Also what ESR and CRP test results would be typical? My ESR is 20 (up from 13 four weeks ago), and my CRP is 6.1 (up from 4.5 four weeks ago). I have hip and shoulder pain late at night and in the morning which I believe is typical. I have had a history of chronic pain (Raynauds, reflex sympathetic dystrophy, endometriosis). My family are all migraine sufferers and my Dad's twin sister has also had a couple of auto-immune diseases. If my polymyalgia would not be suspected what other diseases are likely?
I am hoping to see a rheumatologist about my symptoms - but it may take a few months to get an appointment.
Thanks in advance for any thoughts.
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Your ESR would have to be much higher than 28 (mine) to have Polymyalgia Rheumatica.
I know where you are coming from as I have similar conditions to you - autoimmune hypothyroidism, unstable ANS, migraine variants, glossopharyngeal neuralgia, amyotrophic neuralgia (a brachial plexus neuritis), brainstem demyelination syndrome etc..
I went to a rheumatologist as I had/get red swollen joints, particularly my knees, elbows, hips, low grade temp allot, rash on face and hands and my ANA was positive for lupus but not that high; my ESR was higher, CRP was up, however I did not have a positive complement blood test to get diagnosed with Lupus / Systemic Lupus Erythematosus. That was 2 years ago when I was 41.
Don't bother with the Rheumatologist just look after yourself - no wheat, little dairy - natural yoghurt is safest, no junk/processed foods. Eat goods fats - Omega 3 Oils, nuts and seeds and oily fish.
Read a book by Immunologist William Joel Meggs called "The Inflammation Cure" and follow his eating/food guidelines. Google books has a copy of it. (
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