Understanding and Managing Polymyalgia Rheumatica
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- čas přidán 7. 06. 2023
- If you have been diagnosed with Polymyalgia Rheumatica (PMR) it can be a challenging and painful time. Rheumatologist Dr Pauline Habib and Exercise Physiologist Robyn Yin will discuss how both of their specialties can assist those who have been diagnosed with PMR. They will cover how the diagnosis is made as well as how it can be best managed both in the short and long term.
Our facilitators cover the following:
• How is PMR diagnosed? And what about Giant Cell Arteritis?
• What are the treatment options for those diagnosed with PMR?
• Steroids and Medication Management
• Exercise Management: Can it help?
• Specific Exercise Recommendations for those with PMR
This is Part 1 of a live online event, to access Part 2 please set up a free BJC Connect account. You can do so by heading to www.bjcconnect.com.au/
Want to try live virtual exercise sessions with BJC Health? Start your FREE trial here: www.bjchealth.com.au/exercise.
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Good info. Thanks for posting
Thanks for the positive feedback. Appreciate it.
Thankyou very helpful
Appreciate the positive feedback. Thank you.
My sedimentation rate was 44 which test is that the CRP? But the doctor didnt do the ERS or ESR. Should I have her do it? I wonder why she didn't do that test?
Thank you for your comment. The sedimentation rate you're referring to is likely the erythrocyte sedimentation rate (ESR), not the C-reactive protein (CRP) test. Both ESR and CRP are tests used to detect inflammation in the body, but they measure different aspects. It might be a good idea to discuss with your doctor why the ESR test was not performed and whether it would be beneficial to do so in your specific case.
@@bjchealthAU thank u so much and for responding, yes going to do that.
Does anyone on here have a high BUN creatinine? And low creatinine? Has anyone had the inflammation affect their heart , lungs or kidneys?
Elevated blood urea nitrogen (BUN) and creatinine levels can indicate kidney function issues, while low creatinine levels may point to other underlying conditions. Inflammation from conditions like polymyalgia rheumatica can potentially affect various organs, including the heart, lungs, and kidneys. It's important to discuss any concerns about organ involvement and test results with your healthcare provider to get personalized advice and appropriate management.
Is fasting a good method to use to help pmr?
Yes! Fasting and 0 carb diet to get rid of inflammation.
My ESR and CRP continue to come up **normal**, They've ruled out everything else and insist I must have PMR. Prednisone treatment has worked well so far.
It is not common to have ’normal’ inflammatory markers with active PMR. However, if a person has a baseline inflammatory marker that is at the lower end of the normal reference range, and now the marker has increased to the upper limit of the reference range, it can still reflect PMR inflammation if the symptoms are compatible. Another possibility is ‘PMR mimic’ such as seronegative spondyloarthritis. Keeping in mind that a moderate dose of prednisone ( >15mg/day) can also reduce inflammation related to degenerative arthritis/tendinopathy so improvements with prednisone at a moderate to high dose cannot be used as confirmatory evidence of PMR.
Thank you, for this informative reply.
My friend was diagnosed with PMR in 2007. Her rheumatologist treats her with prednisone 5mg/day. Ups it in times of increased stiffness and pain. Also she gets Rx for 90 tabs of 10mg hydrocodone every 30 days without fail. Is this dose of pain med usual?
It sounds like your friend is receiving a tailored approach to managing her Polymyalgia Rheumatica (PMR) symptoms, with a combination of prednisone and hydrocodone. Prednisone is a standard treatment for PMR, helping to reduce inflammation and alleviate the symptoms of stiffness and pain. The dosage can indeed be adjusted based on symptom severity and flare-ups.
Hydrocodone, on the other hand, is a strong opioid pain medication used to treat severe pain that hasn't responded well to other treatments. While it's not uncommon for individuals with chronic conditions like PMR to require pain management, the continuous use of hydrocodone, especially at the dosage mentioned (90 tablets of 10mg every 30 days), is less common for PMR alone, given the potential risks of long-term opioid therapy. These risks include dependence, tolerance, and opioid use disorder, among others.
The use of opioids in managing chronic conditions, including PMR, typically involves careful consideration of the balance between benefits and risks. It’s often reserved for situations where other pain management strategies have been insufficient. The specifics of pain management, including the use of medications like hydrocodone, should always be individualized based on the patient's condition, response to treatment, and overall health profile.
It's also important for patients and their care teams to regularly re-evaluate pain management strategies, considering both the effectiveness of the current approach and the potential risks associated with long-term opioid use. In Australia, as elsewhere, there's an emphasis on minimizing the use of opioids for chronic pain due to the risks I mentioned. However, every patient's situation is unique, and treatment plans are tailored to individual needs under the guidance of their healthcare provider.
If there are concerns about the pain management approach, it might be helpful for your friend to discuss these with her rheumatologist or seek a second opinion, particularly to explore alternative pain management options that might reduce the reliance on opioids while effectively managing her symptoms.
I was treated for PMR a few years ago. My legs were incredibly stiff. I couldn’t lift my legs off the bed. I couldn’t walk up a curb. Now I am having other symptoms that appear to be MS related (mri scheduled soon). Would PMI present in the way I described? Prednisone helped a lot but I was on it for 2 years.
Thank you for your comment. It is not impossible that PMR results in leg stiffness in the morning. Your treating doctor needs to go through the symptoms in more details, compared to the symptoms you had before , review the inflammatory markers on the blood test to determine if it is from PMR. Sometimes a trial and low dose prednisone 10-15mg/day and help us determine if it is from PMR, which usually responds to low dose prednisone quickly.
@@bjchealthAU my leg stiffness was 24/7. My SED rates were high. If my MRI comes back as MS then I will know it was not PMR. Thank you for responding!
Was diagnosed with PMI with severe aching pains in both my legs. I was able to do nothing until I was prescribed Prednisone. . Now 3:29
For MANY people a huge problem is accesability to see a specialist -I have a 6 month wait! The idea of an “ongoing conversation” with almost any doctor is not possible.
I was diagnosed with PMR and a CRP of 87, which is quite high. It seems that the average levels of CRP are very less like 30 to 45, but not 87. What are your experiences?
I was diagnosed when my CRP was 100.
@@DeniseMaxwell-nb4mb wow... Have you been able to get your inflammation under control?
@@agvision09 Not really. With a combination of Methotrexate and Prednisone I have been managing somewhat. I have now been told that I do not have PMR and my symptoms seem to be evolving from muscle to joint, bone, nerve (just about everything)
@@DeniseMaxwell-nb4mb So sorry to hear that. These diseases are so debilitating and awful! Look into fasting for a few days and very low carb nutrition to get rid of inflammation. That's what I'm doing. God bless you.
I have been told i have PMR,and im in a lot of pain, i now have a really painful scalp when i touch it, and pain in my upper arms.
Please see your doctor and/or your treating rheumatologist and have it assessed as quickly as you can
You need steroids and a lot of tests
Scalp pain needs to get checked..
Prednisone start and tapering until hcq takes effect. Intermittent fasting..Diet without sugar gluten an̈d dairy will do some help..mild excercise once out of pain..stay happy..will be out of pain..just give it some time..
Is steroids a cortisone PANAFCORT? Please advise
I got this from google if this is what you are asking: "Panafcort® is an international brand of prednisone. It is classified as a corticosteroid and is used for severe allergies, severe or chronic asthma, skin problems, arthritis, inflammatory diseases of the bowel, cancer and "auto-immune" diseases."