Classic Presentation of Polymyalgia Rheumatica (PMR)

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  • Опубліковано 17 лис 2024

КОМЕНТАРІ • 130

  • @PeterJohns
    @PeterJohns  Рік тому +2

    Just a reminder that I won't give medical advice to individuals about their particular medical problem.

  • @blackswi
    @blackswi 9 років тому +14

    Thank you. This helped me better correlate the clinical findings to the disease. Please let your patient know how helpful he was!

  • @snussher
    @snussher 6 років тому +12

    Thanks to you for putting this together and the patient for volunteering. Very useful as a medical student!

  • @MSPA-rt9te
    @MSPA-rt9te 7 років тому +7

    Nice! made me smile seeing that he could do the touchdown!

  • @BJane58
    @BJane58 Рік тому +10

    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

  • @rajumallaa
    @rajumallaa 6 років тому +6

    Thank you, Dr. Peter. Very useful for a Physician Assistant students like me.

    • @PeterJohns
      @PeterJohns  6 років тому

      Thanks, I think it's useful for everyone who hasn't seen a case before.

  • @BJane58
    @BJane58 Рік тому +10

    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.

    • @zootybeano
      @zootybeano 8 місяців тому

      I recently got LDN from a pain clinic with a CRNA.

  • @parkercummings1906
    @parkercummings1906 2 роки тому +11

    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.

    • @d_orca
      @d_orca 2 роки тому +4

      I'm sorry to hear. Have you tried the medicine 'prednisone'?

    • @parkercummings1906
      @parkercummings1906 2 роки тому +6

      @@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.

    • @margerettaarmstrong1285
      @margerettaarmstrong1285 2 роки тому

      @@parkercummings1906 m

    • @danacaro-herman3530
      @danacaro-herman3530 Рік тому +1

      ​@@parkercummings1906NO MORE JABS!! THEY ARE NOT SAFE!!!

    • @kandacepatterson7965
      @kandacepatterson7965 11 місяців тому

      Got it 3 days after covid...yikes.

  • @maryailasowens
    @maryailasowens 5 років тому +4

    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.

    • @PeterJohns
      @PeterJohns  5 років тому +1

      Rheumatologist are definitely familiar with this disorder. Glad you're feeling better.

    • @maryailasowens
      @maryailasowens 5 років тому +1

      @@PeterJohns for some reason, they never looked for it until now. I feel amazing.

  • @tracypriest4386
    @tracypriest4386 2 роки тому +11

    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. 😢

    • @blowersm
      @blowersm Місяць тому

      @tracypriest4386 You can't stay on the steroids long-term, though, as it can reduce your bone density for 1 thing.
      I was also diagnosed with fibromyalgia and osteoarthritis. Did they tell you that fibromyalgia is autoimmune also? I think I have heard that.

  • @tiffanyfirkoguglielmelli2130
    @tiffanyfirkoguglielmelli2130 9 років тому +8

    Well done case study. A very helpful learning tool.

    • @PeterJohns
      @PeterJohns  9 років тому

      Thanks!

    • @Daniel777uk
      @Daniel777uk 6 років тому

      is Lovely Testimony!!! God Bless you Peter good Doctor!

  • @M-L450
    @M-L450 2 роки тому +1

    Please present to us more cases!
    This is help for Humanity.

  • @alfredagain
    @alfredagain 6 років тому +7

    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.

    • @PeterJohns
      @PeterJohns  6 років тому +1

      Good to hear!

    • @volt8684
      @volt8684 2 роки тому +3

      Imagine living in dark ages with it no drugs. People criticise prednisilone but it’s a wonder drug as well as the negatives

    • @lillianflorence6056
      @lillianflorence6056 Рік тому +2

      It's good I take them

  • @Saad-ir5bq
    @Saad-ir5bq Рік тому

    These helpful even for medical students! Thank you and please post more videos whenever time allows.

  • @dutoit
    @dutoit 3 роки тому +7

    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

  • @xDomglmao
    @xDomglmao 4 роки тому +4

    Thank you very much! Extremely helpful!

  • @123daystar
    @123daystar 9 років тому +2

    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

    • @PeterJohns
      @PeterJohns  9 років тому +2

      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.

    • @123daystar
      @123daystar 9 років тому +3

      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

    • @d_orca
      @d_orca 2 роки тому

      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?

    • @123daystar
      @123daystar 2 роки тому

      @@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

    • @madeehaahsan83
      @madeehaahsan83 2 роки тому

      @@PeterJohns 50% of PMR cases are associated with giant cell arteritis. But this seemed isolated case.

  • @alaayasser6982
    @alaayasser6982 2 роки тому

    Very helpful! All of your videos are
    Thank you so much 💖

  • @brooksrountree2709
    @brooksrountree2709 Рік тому

    Thank you for posting this video it was very informative

  • @ank9322
    @ank9322 3 роки тому

    great informative video. Thank u so much for this

  • @Farqan86
    @Farqan86 9 років тому +2

    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?

  • @cbryce9243
    @cbryce9243 4 роки тому +1

    Wow, nice improvement!

  • @suziebee2945
    @suziebee2945 2 роки тому +1

    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 ,

  • @aileenpeak9108
    @aileenpeak9108 Рік тому +4

    I know exactly what this man is suffering. Unbelievable pain and going to bed ids he

  • @mikeletterst9882
    @mikeletterst9882 6 років тому +1

    Great job.

  • @sunshine80
    @sunshine80 3 роки тому +3

    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.

    • @PeterJohns
      @PeterJohns  3 роки тому +1

      Hope he feels better soon.

    • @derekglover510
      @derekglover510 3 роки тому +4

      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

    • @genehorton8068
      @genehorton8068 2 роки тому +1

      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.

    • @sunshine80
      @sunshine80 2 роки тому

      @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.

    • @danacaro-herman3530
      @danacaro-herman3530 Рік тому +1

      ​@@sunshine80No more jabs for your husband please!! I'm sorry your family is going through this

  • @jroark101
    @jroark101 2 роки тому +1

    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!

    • @BJane58
      @BJane58 Рік тому

      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

    • @sherryblatt4459
      @sherryblatt4459 3 місяці тому

      @@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!!🙏😔

  • @blowersm
    @blowersm 3 роки тому +1

    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.

    • @BJane58
      @BJane58 Рік тому +1

      Have you gotten better?

    • @Richie07a1
      @Richie07a1 Місяць тому

      I am exactly where you are and wondering how long this is going to last

    • @blowersm
      @blowersm Місяць тому

      @@Richie07a1 I still have some pain symptoms. But it is much better 3 years later. I think it took about a year and a 1/2 to get off steroids and feel somewhat better. Make sure to see a rheumatologist.

  • @aussiegirl2148
    @aussiegirl2148 3 місяці тому

    I got this at age 47 during chemotherapy. I'm 63 now, my doctor said she wouldn't use steroids. I'm thinking of getting another opinion. I'd love to have some relief from the pain.

    • @scoutdixie4412
      @scoutdixie4412 Місяць тому

      @@aussiegirl2148 See someone else. I know how bad steroids are, but within 24hour of starting them I had relief. I could sleep, roll over without waking up. I weaned the dose pretty quickly, pain returned but not as bad. It gave me time to rest, regroup. Not sleeping is probably worse than anything prednisone could do to you.

  • @rdgarcia6081
    @rdgarcia6081 2 місяці тому

    I know you don't give out medical advice. I got diagnosed with PMR LAST month. Inwas working at a warehouse for two years. My body was always tired and muscle pain and stiff ess. Then amazon let me go because my rate was very bad. I take presidone 10 mg. It relieved some pain throughout about 15 hours bit still get very tired bathing is very hard still and even tried cutting hair. I will tell this to my doctor. I just wished the headaches would go away too. But i do agree it jelped a little bit though. I can actually get out of bed easier and lift my arms up bit not for a long time like cutting hair

  • @KidHuevotes00
    @KidHuevotes00 9 років тому +1

    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

    • @PeterJohns
      @PeterJohns  9 років тому +1

      Norman Schopenhauer Glad to provide the water!

  • @jedheart8059
    @jedheart8059 Рік тому +1

    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.

  • @LMMLR4
    @LMMLR4 Рік тому +2

    I wonder is there a rebound affect after steriods are tapered off?

    • @PeterJohns
      @PeterJohns  Рік тому +2

      My understanding is that is something you have to watch for.

    • @brianmurphy8032
      @brianmurphy8032 8 місяців тому

      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

  • @zootybeano
    @zootybeano 8 місяців тому

    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.

  • @tammiefi8716
    @tammiefi8716 18 днів тому

    Can you have symptoms starting in your 30's I am 40 now. Doctor's are not sure what I have as yet.

  • @nonegiven9579
    @nonegiven9579 9 місяців тому

    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.

    • @Richie07a1
      @Richie07a1 Місяць тому

      Well, that's depressing 🥴

  • @lrwhit6456
    @lrwhit6456 Рік тому

    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?

    • @PeterJohns
      @PeterJohns  Рік тому

      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.

  • @alias201
    @alias201 6 років тому

    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!

    • @PeterJohns
      @PeterJohns  6 років тому +1

      28 would be very young for PMR. I'm not even sure if it's been reported in someone that young.

    • @alias201
      @alias201 6 років тому

      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.

    • @kandacepatterson7965
      @kandacepatterson7965 11 місяців тому

      Mine feels like a knife scraping my bones and joints

  • @Droneaway-72
    @Droneaway-72 3 роки тому

    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

  • @ilcampanello-holidayhomein5513
    @ilcampanello-holidayhomein5513 8 років тому +2

    I wish you would publish your credentials. Why don't you?

    • @PeterJohns
      @PeterJohns  8 років тому

      Interesting question. Not sure why it would matter. In any case, I do list them on other videos.

    • @ilcampanello-holidayhomein5513
      @ilcampanello-holidayhomein5513 8 років тому +4

      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.

    • @emilygreer4636
      @emilygreer4636 7 років тому

      Pe
      Johns !

  • @anthonysalgado5118
    @anthonysalgado5118 3 роки тому

    I have PMR from the beginning of the year I started on 20mg prednisone and I am on 10 mg now.

    • @d_orca
      @d_orca 2 роки тому

      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?

    • @anthonysalgado5118
      @anthonysalgado5118 2 роки тому

      @@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.

    • @d_orca
      @d_orca 2 роки тому +1

      @@anthonysalgado5118 Thank you for your response. My father may need this same treatment. I wish all the best for you. Take care.

    • @volt8684
      @volt8684 2 роки тому +1

      @@anthonysalgado5118 3 yrs can get down to 2mg before relapse 63 yrs old

  • @tombloom99
    @tombloom99 7 років тому

    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?

    • @PeterJohns
      @PeterJohns  7 років тому +2

      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.

    • @tombloom99
      @tombloom99 7 років тому +3

      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!

  • @AmirAnsari-et9tn
    @AmirAnsari-et9tn 9 років тому +1

    First, thanks for this excellent presentation. Did you check for Temporal Arteritis?

    • @PeterJohns
      @PeterJohns  9 років тому

      Amir Ansari As he had no headache or jaw claudication or visual symptoms, he did not have temporal artery biopsies.

    • @kandacepatterson7965
      @kandacepatterson7965 11 місяців тому

      My doc did yhis teat for me today.

  • @Mum2cuties
    @Mum2cuties 2 роки тому

    From what I understand exposure to severe cold is a trigger. Is this correct?

    • @PeterJohns
      @PeterJohns  2 роки тому

      I am not aware of cold exposure causing PMR. Maybe making it worse. It's always cold in our area in the winter LOL.

    • @BJane58
      @BJane58 Рік тому

      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.

  • @aaerosteve2823
    @aaerosteve2823 3 роки тому +2

    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.

    • @PeterJohns
      @PeterJohns  3 роки тому +2

      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.

  • @SharpLife4
    @SharpLife4 Рік тому

    Can’t be one side shoulder and hip or always both

    • @PeterJohns
      @PeterJohns  Рік тому

      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

  • @ahmedthamir9531
    @ahmedthamir9531 2 роки тому

    nice !!

  • @johnbovard8454
    @johnbovard8454 2 роки тому

    100% similar experience.

  • @susankolberg963
    @susankolberg963 4 роки тому +1

    Prednisone has devastating side effects. Almost worse than my pmr.

    • @PeterJohns
      @PeterJohns  4 роки тому

      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.

  • @arydant
    @arydant 4 місяці тому

    My only difference is that it sarted in my hips first.

  • @emiliahara5000
    @emiliahara5000 7 років тому +9

    very useful, only i thought that the doctor should help him to get up not ask his wife really.

    • @PeterJohns
      @PeterJohns  7 років тому +8

      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.

    • @copout1405
      @copout1405 3 роки тому +1

      @@PeterJohns Good save with the camera bit

    • @ginoasci
      @ginoasci 2 роки тому +1

      what kind of doctor are you, and how do you run your office?

    • @billbauer9795
      @billbauer9795 Рік тому

      @@ginoasci In another comment below this video he said that he is an emergency doctor.

  • @richiejohnson
    @richiejohnson 2 роки тому

    That man could be me.

  • @rhodamaria
    @rhodamaria 6 років тому

    10 thumbs up!

  • @jd1iraq
    @jd1iraq 9 років тому

    Nice job

  • @kandacepatterson7965
    @kandacepatterson7965 11 місяців тому

    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