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Even though they've tested me, could something else be going on or can PMA affect the thoratic region of the spine as well as shoulders and hip?

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Here's my concern:  when the pain came back it was mainly in my ribcage area -- the stermum, and the backbone behind the sternum. I see stars when I sneeze.  I feel confident it's muscle or tendon related because it only hurts when I move -- not when I'm still.   Shoulders hurt a bit also, but mainly thoratic region of the spine.  With all that I've read, PMA does not apprear in this region.

I was diagnosed in January of this year and the pain that drove me to the doctors was rib cage and mid back pain. It had got to the point where I couldn't breathe in without intense pain. I was also getting pain in my shoulders and upper arms. Luckily the doctor I saw diagnosed PMR immediately and started me on 15mgs of pred. Within two days the chest/back pain had gone. It was an immense relief. The arm/shoulder pain diminished but has never completely gone and is always the first to get worse when I try to reduce my pred dose (no matter how slowly). I have currently reduced to 13.5mg but cant get any lower. Even at this dose the arm pain/fatigue has increased. Sorry, I've digressed from your question! Anyway, I would say that, yes, chest/ribcage area pain can definitely be part of PMR. In your place I would go back up to a dose that eliminates it, wait a while and then try the reduction again. Good luck. Hope you are painfree very soon. Debbie

As for taking it all at once or dividing the dose, I have always been told it is best to take the whole dose @ around 9-10 am.  Taking it this ways allows your adrenal glands to continue to secrete cortisol, which is most active between 3-4am..

I was in a lot of pain from my neck to my legs -- I couldn't get dressed alone.  Doctors put me on prednisone and within 12 hours the pain was gone.  60 mg/day at first, then tapering down to 8.5.

I think lack of collaboration with labs seems to be a common thing with auto immune dx.  By the time my labs came back positive, I was in full blown PMR!

Thanks for all this.  I think they started me on such a high dosage because they were afraid of GCA.  My neck and head were bad -- couldn't turn my head a bit.  I could not get out of the car.  It took me about a minute after standing to be able to walk.  The 60 MG /day wiped it out in a day.  I could not believe it.

Today is the first day I feel my blood glucose level have stabilized and I'm not shaking all the time!   That is how sensitive I am to Prednisone!  .As far as the pain goes, it is managable with my Norco.  I take it on a routine basis rather than as needed!

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It often happens alongside PMR - and it is possible that was what started it all off. It is a shame in a way they used such a high dose of pred. The normal PMR starting dose is 15-20mg, 60mg is what is used where GCA is suspected to avoid loss of sight. 60mg would have relieved the myofascial pain syndrome as well and it is only returning now you had got down to a more normal PMR dose. It is likely that 9mg is the "maintenance" dose for you for your PMR for the moment. I repeatedly got stuck at 9mg with a return of pain any lower - until the local pain specialist started to get the more localised bits sorted out (she's an anaesthetist) using the techniques I mentioned. Mine all went haywire starting with sacroiliacitis after tripping but all the muscles in my back were totally solid in spasm. The bit that hurt most was the thoracic area over a long period, then the sacroiliac joint was the weakest point and triggered the rest.

The trigger points can be dealt with using mobilisation therapy as used in sports massage or by a physiotherapist. Or cortisone injections can be given into the trigger point itself. I also got great relief from Bowen therapy - I can't remember what it is called in the USA.

I've had sudden shoulder, then middle back, then lower back and leg pain since March, 2014 (debilitating within 3 weeks).  Doctors did extensive blood work and MRI's to rule out anything else, and then determined that I had "undifferentiated inflammatory arthritis."  When I suggested to the doctor that it might be polymyalgia rheumatica, he said "yes it could be, although it's presenting itself a bit differently."

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