Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Neck Pain When Suffering From Polymyalgia
Question: I have had polymyalgia and arterial artiritis for the last two years. My steroids are now down to eight but my neck pain is S bad and I just feel so tired achy and weary everywhere. I am beginning to think it is in my mind. My neck feels like there Fingers pressuring all over it and hurting it just like when I was first diagnosed. I am getting headaches at the front of my head and temples more often. Should this now be all gone and can I be imagining it, although I know really I am not. My blood levels are not too bad now compared with what they used to be. I get so tired and achy . Your advic would be appreciated
Brief Answer:
PMR takes a LONG time to resolve
Detailed Answer:
Good afternoon. My name is Dr. Dariush Saghafi and I am a neurologist.
There is no absolute set standard practice of how to taper people down on their steroids if the diagnosis of PMR is made. However, the way most people will do it is to calculate a process of tapering (once the patient responds to initial steroid therapy) such that the entire process to get the patient off and feeling back to relatively normal is 1-2 years. In my experience most patients will need to get the full 2 years if you use the ESR (sed rate) or CRP (C-reactive protein) are used to measure disease activity.
Also, on average it is said that people using about 10mg/day of steroid should be brought down at the rate of 2.5mg. on a monthly basis while below 10mg./day the recommendation is to reduce by 1mg./every month assuming that no flareups occur. If there are no flareups of your symptoms over the taper down period then, most people will be able to get taperd off right around 1 year.
From a clinical perspective what we're looking for is less stiffness and pain in the neck, shoulders, and hip girdles in the mornings upon awakening.
You probably don't want to hear that I've treated patients with steroids for as long as 3 years before being able to taper OFF. And my record holder patient so far? 5 years....!
If you believe that the pain and discomfort now that you're tapering down is exactly the same as when you were first diagnosed then, you definitely need contact your physician because that's not supposed to happen.
It's better to report to your physician that your pain symptoms are really NOT getting better if they tell you that they should because the worst that can happen is you may remain on treatment for a few more months....maybe even longer....look at the numbers I shared with you up top.....because otherwise, if you don't say anything or you minimized what's going on thinking that you'll get over it then, it'll catch up with you and you will be in such pain eventually that you will literally think that you've never gotten treatment and then, they will have to set it all again.
If any of the information I've asked or provided has been useful to further your understanding or give you ideas as to which direction to turn next and you'd like to CLOSE THIS QUERY then, could you do me a favor and leave some brief feedback with a STAR RATING for the quality of the response.
Alternatively, we could continue this conversation and you may upload information if available such as lab tests, etc. and I would be happy to review them.
Please feel free to contact me at any time to ask more questions about this or any other topic you would like by using the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 26 minutes of physician specific time to review, research, and compile the final draft for envoy.
PMR takes a LONG time to resolve
Detailed Answer:
Good afternoon. My name is Dr. Dariush Saghafi and I am a neurologist.
There is no absolute set standard practice of how to taper people down on their steroids if the diagnosis of PMR is made. However, the way most people will do it is to calculate a process of tapering (once the patient responds to initial steroid therapy) such that the entire process to get the patient off and feeling back to relatively normal is 1-2 years. In my experience most patients will need to get the full 2 years if you use the ESR (sed rate) or CRP (C-reactive protein) are used to measure disease activity.
Also, on average it is said that people using about 10mg/day of steroid should be brought down at the rate of 2.5mg. on a monthly basis while below 10mg./day the recommendation is to reduce by 1mg./every month assuming that no flareups occur. If there are no flareups of your symptoms over the taper down period then, most people will be able to get taperd off right around 1 year.
From a clinical perspective what we're looking for is less stiffness and pain in the neck, shoulders, and hip girdles in the mornings upon awakening.
You probably don't want to hear that I've treated patients with steroids for as long as 3 years before being able to taper OFF. And my record holder patient so far? 5 years....!
If you believe that the pain and discomfort now that you're tapering down is exactly the same as when you were first diagnosed then, you definitely need contact your physician because that's not supposed to happen.
It's better to report to your physician that your pain symptoms are really NOT getting better if they tell you that they should because the worst that can happen is you may remain on treatment for a few more months....maybe even longer....look at the numbers I shared with you up top.....because otherwise, if you don't say anything or you minimized what's going on thinking that you'll get over it then, it'll catch up with you and you will be in such pain eventually that you will literally think that you've never gotten treatment and then, they will have to set it all again.
If any of the information I've asked or provided has been useful to further your understanding or give you ideas as to which direction to turn next and you'd like to CLOSE THIS QUERY then, could you do me a favor and leave some brief feedback with a STAR RATING for the quality of the response.
Alternatively, we could continue this conversation and you may upload information if available such as lab tests, etc. and I would be happy to review them.
Please feel free to contact me at any time to ask more questions about this or any other topic you would like by using the following link:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474
This query required 26 minutes of physician specific time to review, research, and compile the final draft for envoy.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
