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This is a condition from which the cause is unknown, it could be hereditary or from environmental factors and is more common in those over 65 years.
It causes muscle stiffness throughout the body and is more prevalent in the early hours after waking. It makes it difficult to even move until after a few hours each morning.
It is very painful and in 20% of cases can develop into a more serious condition called Temporal Arteritis or Giant Cell Arteritis. In those conditions the arteries in the head can become severely inflamed. That can cause strokes or blindness and requires urgent attention. That will show in symptoms like headaches, sore and tender scalp, even pains in the jaw or teeth, and can, after some double vision, lead to blindness.
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My Personal Journey with PMR to date
Coming up to Christmas 2023, I began to feel that I had a recurrence of the Gout I’d written about in an earlier article. I wasn’t sure, but kept getting old injuries playing me up. My knees hurt, and my feet hurt, but only intermittently. Then, after a fairly rigorous gym workout, I felt as if I’d tweaked an old back injury that brought on Sciatica. It was making it difficult to move; getting in and out of the car was painful, and my general movement was slow.
In desperation I went online and sought out a Chinese Acupuncturist Clinic, for that form of treatment had worked when my back pain and Sciatica had surfaced previously. After a few weeks of treatment with needles, cupping, and many herbal tinctures, my back pain had eased, but my movement was still limited.
I reached a point when I made an appointment with my GP to ask if the Gout had returned but to other areas of my body. I had already had a blood test earlier to check my blood sugar as my weight had been pushing me towards Type 2 Diabetes. My Doctors had prescribed Metformin to drive the blood sugar issue down and recommended that I get some Folic Acid as a supplement because I was slightly anaemic.
I had let myself go since the COVID-19 lockdown period; I had put on weight and become unfit, hence my re-joining the gym before pulling a ligament in my back.
I was desperately struggling day by day as the inflammation crept up my body. It was getting harder to carry out ordinary tasks. Getting out of bed at night was painful, and rising from a seated position was difficult without leaning on a piece of furniture or a stick. Raising my hands to shampoo my hair in the shower was impossible without the aid of the other hand. On waking, just my legs touching the duvet was painful, and getting dressed became awkward. I couldn’t lift one leg to put my jeans on. It would take me a few hours to get moving each day. I was carrying out my work tasks, showing people properties and handing them over, but I had to allow extra time and a stick as assistance if stairs were involved. I was in a constant stiffness and pain.
I was taking Ibuprofen for the pain and it would help for short periods during the day, it certainly helped me get going in the mornings. However, taking three or four per day was not recommended, and I just knew something bad was going on with my body.
After a week or so more, I got to see a newly appointed Doctor at our local GP Clinic as an urgent appointment, thinking I had continuous gout. After a brief consultation, he gave me a form and told me to get an immediate blood test. Within a week, the Doctor telephoned me at home and asked if I could attend the surgery the next day. That was when he explained to me that I had Polymyalgia Rheumatica or PMR.
I was immediately prescribed a course of a steroid called Prednisolone 3 x 5mg per day, along with another tablet, Omeprazole 20mg daily. The second pill, ostensibly, is to stop any gastric problems I might get from being on the steroids.
It took a few days, but I could feel the pain and inflammation easing. Within two weeks, I felt great. My movement improved, and I could even grip the shampoo bottle and raise my hands enough to wash my hair. Another month, I could get back to the gym and start doing light cardio workouts, but with no weights or muscular tension.
I was also referred to a website dedicated to people with PMR, where I could discuss the condition with other sufferers: https://healthunlocked.com/pmrgcauk/
Those experienced sufferers on that website offered incredible worthwhile advice on how to handle the many effects of this horrible condition.
The steroid prescription is so strong that once the condition is under control I have been guided to reduce the dosage gradually over a period of 46 weeks. From starting at three tablets of 5 mg each day I am now down to one 5mg in the morning and 4mg in the evening. With luck and no further symptoms I’ll be down to 3mg in the evenings next week tapering down by one milligram every 4 weeks.
From talking to other sufferers on the website it is possible to get other flare-ups of the inflammation and to have to revert back up the dosage again. Some sufferers on the website have been on these steroids for many years, six or seven years is not unusual. Along with that long term use of the steroid comes the possibility of other reactions. Apparently, being on the steroid can increase your blood sugar and the possibility of type 2 Diabetes.
My progress is gradually working according to the Doctor’s plan, which I have had to assist with my own fitness plan.
When first diagnosed with PMR and realizing the enormity of my condition I understood that I had to take this as a sign that I’d let myself go to such a state that I had to kick myself into a new fitness regimen.
I immediately put myself on a “No Carb Diet” eliminating all bread, pasta, rice and potatoes from my meals. I stuck with meat, fish, and vegetables only. On the Doctor’s advice I added Cheese for the calcium required. The steroid use also appears to have an effect on the bones and I was encouraged to take another drug, Alendronic Acid at 70mg each week to apparently strengthen them.
That diet knocked some 30 pounds of weight off over a very short period of some 6 weeks.
I was so pleased that I could now get back into many clothes that I had grown out of. I am definitely feeling like a new man.
The gym workout has to be tempered to lighter weights as the underlying condition could react badly to the muscular tension. I have noticed that if I overdo the push ups the quite normal body stiffness feels like the original inflammation has returned, and I have to take it easy for a few days. You have to be ever watchful, constantly taking notes or consulting the other sufferers on the website.
PMR can lead to other Rheumatic or Arthritic illnesses or complications so I’m treading very carefully in sticking to my recovery plan.
Sources:
Personal Descriptions
https://www.nhs.uk/conditions/polymyalgia-rheumatica/
https://www.mayoclinic.org/diseases-conditions/polymyalgia-rheumatica/symptoms-causes/syc-20376539#
https://versusarthritis.org/about-arthritis/conditions/polymyalgia-rheumatica-pmr/
https://pmrgca.org.uk/
