Please could you tell me if fibromyalgia is similar to polymyalgia rheumatica? I take Predisilone for polymyalgia which started eight years ago. I am 88 years old. Sometimes the problem clears up for a while, then returns. Please could you advise?
Dr Mike Martin, Consultant Rheumatologist, Spire Leeds Hospital
Your question demonstrates that the terminology used by doctors is often confusing for patients.
Fibromyalgia is a condition characterised by aches and pains, generally unrelated to inflammation, and it will not respond to treatment with steroids such as Prednisolone.
Polymyalgia rheumatica (PMR), on the other hand, is a recognised inflammatory condition and invariably will get better with treatment by steroids.
Prednisolone prescribed for PMR can usually be withdrawn after a limited treatment period. In some cases, however, it may take as long as two years for symptoms to settle.
However, for some people, symptoms do return and relapsing PMR is a recognised disease. It will usually respond each time to a short course of steroids and only a few patients need life-long treatment. In your case, one explanation for continued symptoms may relate to reduced natural cortisol (steroid) production by the adrenal glands, and these circumstances may require long-term replacement therapy.
I suggest you discuss these issues with your own GP as they may require further investigation.