Classic Presentation of Polymyalgia Rheumatica (PMR)
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- Опубліковано 3 гру 2014
- This man presented with about a month of bilateral shoulder pain and stiffness. He graciously consented for his story to be posted on youtube to help educate doctors and patients about Polymyalgia Rheumatica. Here are two more videos of patients have with PMR. • Two more cases of Poly...
Just a reminder that I won't give medical advice to individuals about their particular medical problem.
Thank you. This helped me better correlate the clinical findings to the disease. Please let your patient know how helpful he was!
The one thing not mentioned is the excruciating fatigue. But like the guy says you can’t sleep or move to your side in bed so some degree of fatigue is always there
Extreme fatigue
@@sherryblatt4459 yes, it is just overpowering
Thanks to you for putting this together and the patient for volunteering. Very useful as a medical student!
Thanks Nathan!
I’ve had PM for 3 years and have been on Steroids for 2 years. When I first starting them I could of literally run a marathon I felt so well. Unfortunately I was also diagnosed with Fibromyalgia and Osteoarthritis. I have now had to cut down on steroids but take methotrexate in replace of them. I’m 57 tomorrow but my body feels so much older. I cannot do half as much because of the pain, but it’s now something I’m going to have get used to as even with physio nothing helps as much as the steroids did. 😢
I was on a ten day 20 prednisone a day. My symptoms were exactly like this man’s only I could barely walk. A walker is of no use because of the pain in shoulders and arms. Within hours of taking first pill I was better. It came back but not nearly so bad. Trying to eat only anti inflammatory food and no sugar . Want to try low dose naltrexone but can’t find a doctor who prescribes.this is a really mean and vicious disease.
I recently got LDN from a pain clinic with a CRNA.
Nice! made me smile seeing that he could do the touchdown!
Thank you very much! Extremely helpful!
Very helpful! All of your videos are
Thank you so much 💖
These helpful even for medical students! Thank you and please post more videos whenever time allows.
Nobody know how bad the pain is My MD HAD ME SUFFER FOR TWO MONTHS WITH ALL THE SIMTOMS AS THE ABOVE AND 1000 OF RANDS LATER please forward this video to al MD s in the world
I got these same symptoms when I was given the second vaccine for Covid 19. Within twelve hours of that shot I was experiencing this pain. I just saw your video randomly in my recommendeds and I believe I have this. Seven months later after the shot I still eperience all this pain.
I'm sorry to hear. Have you tried the medicine 'prednisone'?
@@d_orca Thank you. I understand the prednisone would help but there are so many side effects and some lifelong that I shy away from that drug. I did find some articles about an anti-inflammatory diet. I am trying this method. It will be slower to work but will help. Actually, I didn;t mention that the first covid19 vac. made me feel sick the first 9 or ten days. I told the woman that that was going to administer the second shot. She didn't seem concern and said there was mild side effects. So, I took the second covid 19 vaccine. And all those symptoms came back and have stayed since. I don't know why the shots effected me this way but they did. Thank you for your concern and suggestion.
@@parkercummings1906 m
@@parkercummings1906NO MORE JABS!! THEY ARE NOT SAFE!!!
Got it 3 days after covid...yikes.
Great job.
great informative video. Thank u so much for this
Please present to us more cases!
This is help for Humanity.
Thank you for posting this video it was very informative
Thank you, Dr. Peter. Very useful for a Physician Assistant students like me.
Thanks, I think it's useful for everyone who hasn't seen a case before.
I know exactly what this man is suffering. Unbelievable pain and going to bed ids he
I have been searching for an answer for over two years now. The only thing that I was getting from rheumatology and from my family physician was that it was definitely an autoimmune problem but they were baffled as to what it was. I found an emergency room doctor yesterday who is familiar with this and ran tests to rule out other issues. He started me on the prednisone last night, and I swear it's a miracle. This is the first day I have had in two years pain free. I thank God that someone actually took the time to listen and had the knowledge to look. I think it was an unusual situation for me and my doctors to find because I'm only 52.
Rheumatologist are definitely familiar with this disorder. Glad you're feeling better.
@@PeterJohns for some reason, they never looked for it until now. I feel amazing.
Wow, nice improvement!
Well done case study. A very helpful learning tool.
Thanks!
is Lovely Testimony!!! God Bless you Peter good Doctor!
Got my diagnosis today. All the symptoms are virtually identical to mine. Worst in the morning, pain mainly in the shoulder area, changing position in bed agonizing, unable to lift arms. And prednisone works wonders. I'm back to normal until I run out of pills.
Good to hear!
Imagine living in dark ages with it no drugs. People criticise prednisilone but it’s a wonder drug as well as the negatives
It's good I take them
I’ve just been diagnosed with this , they said I had ra first , although I’m worried I’ve been getting bad jaw pain and headaches for a few months now and under my eye swells up too ,
nice !!
what a nice chap !!!!!, just had the same symptoms and now on prednisolone 30 mg, the pain was terrible in all major joints from neck to knees, as i'm 58 yrs i feel sorry for this poor fella, must have been traumatic
Chris Skelson He is a very nice man. He did suffer, as he says in the video. Since I saw this man initially, I have seen at least 2 other patients with a new diagnosis of PMR in the emergency department. It seems to be under recognized by doctors in general.
Peter Johns
hi peter, after 6 hrs on prednisolone 30mg, i was back to 80 percent fit, have a very thorough doctor who diagnosed my polymyalgia quite quick, lucky me
Hi chris, im sorry to hear that you had the same symptoms. It must have been painful. How are you feeling after taking prednisolon? Did the pain come back after stopping the medicine? Did you need to keep taking the medicine?
@@d_orca luckily 18 months of predisilone cured it, my guess is 3 years to get back to full fitness though, a great relief when it went away
@@PeterJohns 50% of PMR cases are associated with giant cell arteritis. But this seemed isolated case.
What is the duration of the corticosteroid therapy and is there a tapering period?
Is it typically PO or can one do IM injections in the affected joint space?
My doctor must have seen this video. This is almost like our interview went when he diagnosed me with PMR. I cannot get through 24 hours without pain on 20 mg of Prednisone which dr has now dropped to 15 mg. I've been taking it for 10 days.
Have you gotten better?
10 thumbs up!
100% similar experience.
Wow amazing how effective tx is in these patients. The primary care Dr I rotated with told me how these patients will be in so much pain and just within 24hrs of prednisone will feel great!
There is one problem with prednisone…….I have glaucoma and have already lost much of my sight. I cannitbrisk the high pressures, have had this horrid disease for a month.,I live alone and everything this man says is 100 per cent true. The wait for a rhemotologist in my area is anywhere from four to 18 months. The pain is torture somi must think of a way to stop it
@@BJane58same here! Waiting to see the Rheumatologist and was so disappointed, she wants me off prednisone but that’s the only thing that helps me! I know the side effects but what choice do we have?? She wants me to start in zevara but the side effects of that drug are over the top for me !! No thanks!!!! Very sad and she never checks my blood work to see what else could be going on!! Seven vials of blood??????? I’m not going back to her!!🙏😔
Had pmr now for a few months
Tried steroids but didn’t work
Now on meloxicam still don’t work for last 14 days .
Hopefully something will work at some point
Thanks my friend, very useful video. Do you know what is the best glass of water? The one you get when you are thirsty. So thanks
Norman Schopenhauer Glad to provide the water!
15 mg of prednisolone took 2.5 hours to bring me back to feeling normal. Prob is that 4 years on and I've only managed to reduce to 4 mg and that's not really enough to clear all the symptoms.
I am so textbook, my family practice doc is scared to diagnose it so I have to get rx for pred from local retired internist friends.
He gets out of bed like I do in my mid-50s. It's severe in the morning. I need to walk around, do things to feel better somewhat. It does get worse sitting. I was given low dose Prednisolone for asthma attacks. I notice my pain went away. But i can only get the prescription for the seasons of the tear my asthma worsens.
😔🙏
My gp thinks I may have this, but I'm only 28. So I'll have to see. Going to get tested first, osteopath and physio. It's so painful that I can't lift my head sometimes. I CAN move my arms, but it hurts so much that I stop. I think mine is more to do with a musculoskeletal issue, but we'll see. I hope it's something that physical therapy and exercises can fix!
28 would be very young for PMR. I'm not even sure if it's been reported in someone that young.
Peter Johns yeah, he said it's very strange, so I've been referred on. My examination looked very similar to this, though, except I hurts to straighten my neck up.
Mine feels like a knife scraping my bones and joints
I have PMR from the beginning of the year I started on 20mg prednisone and I am on 10 mg now.
Hi Anthony, sorry to hear that you have PMR. How are you feeling now? Are you still taking prednisone? Does it make you feel better?
@@d_orcaThank you yes I still take prednisone 15 mg and it does work as I have no aches and pains now. I weened myself of off 20 mg to 10 my pain stopped so I got clever and stopped taking it completely but the aches flaired up again so I had to go back onto prednisone.
@@anthonysalgado5118 Thank you for your response. My father may need this same treatment. I wish all the best for you. Take care.
@@anthonysalgado5118 3 yrs can get down to 2mg before relapse 63 yrs old
I have the same symptoms, but, with lower back pain instead of hip pain.
Does there have to be hip pain included to diagnose it as PMR?
The diagnosis is made by a doctor, and that is where you should seek medical advice. I will say that patients with PMR do not have to have hip pain to meet diagnostic criteria of PMR.
My husband lost 30 pounds of muscle mass in 3 months and has pmr. He woke up 10 days after the 2nd pfizer covid-19 vaccine . We thought that he was dying. Took 4 months to get a diagnosis. He has been on steroids for 5 days with just a little improvement.
Hope he feels better soon.
exactly the same with me. 10 days after the 2nd Pfizer i could hardly move. Was prescribed prednisone & just amazing
I feel the Pfizer kicked this off & nobody is talking about it
Are these cases being referred to pfizer? There was a several page list of possible problems that Pfizer released. In that list it asked for all medical professionals to be sure to report any problems from the list.
@Derek Glover my husband is currently on his 5th day in the hospital where he has been receiving IvIg infusions each day. His labs are still all out of whack 😤. I'm not really understanding all of the cause and effect. I'm currently doing a lot of reading and research. I do believe that all of this is being reported however I definitely will ask the drs today. I will definitely be contacting an attorney.
@@sunshine80No more jabs for your husband please!! I'm sorry your family is going through this
Nice job
My history is very similar. My question is, what will happen in the next few years? Dr Johns offers no prognosis or follow up. What is his patient's situation now? His prednisone dose?
The title of the video is "Classic presentation of PRM". My focus is to allow emergency physicians (and others) to be able to recognize when they should suspect a patient has PMR. For more detailed information I advise you to contact a health care professional.
Thanks for your reply. I am a health care professional, retired ED doc. No one on the internet offers any information on the prognosis of this condition. Did you see this patient in the ED, or in your office? Was there any follow up?
Just trying to get more information. I now don't live near any rheumatologist, and the course of the illness should be commonly available, if known. Was just curious how this guy did.
I seem to need 5 mg/day one year out.
Thanks for your video, and best wishes!
First, thanks for this excellent presentation. Did you check for Temporal Arteritis?
Amir Ansari As he had no headache or jaw claudication or visual symptoms, he did not have temporal artery biopsies.
My doc did yhis teat for me today.
From what I understand exposure to severe cold is a trigger. Is this correct?
I am not aware of cold exposure causing PMR. Maybe making it worse. It's always cold in our area in the winter LOL.
This is how I believe I got mine. I have had stiffness for several years with no pain. In December I worked outdoors (sedentary work) for 7:hours. Got too cold and too tired.
I wonder is there a rebound affect after steriods are tapered off?
My understanding is that is something you have to watch for.
I tapered from 20 mg. Down to none over 18 months stopped and it came back. Not so bad so I started again at 10 mg. Tapered. To none over 1 month I still have shoulder / neck pain. But use exercise to regain mobility. The pain is still there. But managebull Glad to be off steroids @@PeterJohns
Can’t be one side shoulder and hip or always both
I'm not entirely certain about that, but here is what I found when I googled it. "At presentation, symptoms may be unilateral but they usually become bilateral within a few weeks." Source: emedicine.medscape.com/article/330815-clinical
Prednisone has devastating side effects. Almost worse than my pmr.
I'm sorry to hear of your bad experience. Many people do very well with prednisone. As an emergency physician the goal of this video was to increase the awareness of the diagnosis. I am by no means an expert on the therapy of PMR.
Yes, but then what? You can't take it forever. When my mother in law stops taking 5mg of prednisone, all pain comes right back. She's been on it for months.
My focus in this video is to increase awareness of the diagnosis. I don't follow the patients with the treatment, as I am an emergency physician.
I wish you would publish your credentials. Why don't you?
Interesting question. Not sure why it would matter. In any case, I do list them on other videos.
Well thank you for coming back to me so quickly. Just suppose I am a volunteer working on social media for a charity that gives support to people with PMR and GCA. I might want to post a link to your video on the charity's website or online forum. And I might need to run it past a medical advisory panel. It would help to know whether you are a rheumatologist, a family doctor, a neurologist or a professor of emergency medicine. Without having to scroll through other videos to find out. Thank you.
Pe
Johns !
My only difference is that it sarted in my hips first.
That man could be me.
Me, too
Same just 3 months ago..could barely get out of bed seriously worse pain ever. Have had hip replaced anal sirgery gall bladder...cant even roll over in bed lost 10 lbs 3 months. Finally diagnosed. We shall see..probably pred. And celebrex
very useful, only i thought that the doctor should help him to get up not ask his wife really.
I wanted to illustrate a characteristic feature of PRM, where they are unable to get out of bed by themselves. Since I was holding the camera, it made more sense that his wife would do it.
@@PeterJohns Good save with the camera bit
what kind of doctor are you, and how do you run your office?
@@ginoasci2876 In another comment below this video he said that he is an emergency doctor.