Is prednisone withdrawal or use of imuran causing joint pain?

My guess is prednisone is the culpirt.  I was on varying doses; 10mg-40mg for over 2 years.  Mostly I was on the low dose side.  After surgery I tapered off 10mg and had raging joint pain for about one full year.  I just buckled down and grinned and got through.  By then I was OVER taking drugs (had been on 22-25 pills per day for UC) and refused to take anything else.  Most likely this pain will go away but it might take time.

Sue

Thanks Sue.  After reading much online about this, it could very well be the fact that I am no longer on the prednisone.  I was weaned off of it properly.  I had my daily dosage decreased by 2.5mg per week until I went from 30mg/day to nothing.  My joing problems became a problem when I got down to below 10mg/day.  The level of pain/stiffness has stayed he same for the past 6 weeks being completely off the prednisone.  (It is less and tolerable when I take either vicodin or darvocet)  I tried taking tramadol (ultram), but it was like taking a couple of tylenol.  It had virtually no effect, so I abandoned it after just a 3 day trial.

I'll see what the rheumatologist has to say a few weeks from now if the pain hasn't subsided or gone away by then.

 

Hubby came off prednisone in Dec. and he suffered with joint pain primarily in his shoulders and hips. I too was wondering if it was the azathioprine that was increased from 75 to 150 mg in Nov. One month later the tapering schedule of the prednisone had him off it finally. The Dr insisted it was not the aza. and the prednisone was probably it and it would go away eventually. He started in August on the fosamax so we were thinking maybe that was that contributing to it.

Add to that his primary care upped his zocor from 20 to 40 mg and then wham....very debilitating joint pain. We stopped the fosamax as our research made us think that was doing it. No change. The Mayo Dr's guess was the increase of the statin drug which made sense. So he went back to the 20 mg of zocor and back on the fosamax....within a month the hip pain was gone and his shoulders are doing much better.

So 8 months after coming off the prednisone and cutting back to the 20 mg of zocor he has been on for about 7 years with no ill effects and things are much better. So I have to agree that the prednisone's effects that can take up to a year I hear to completely leave your system was the main culprit. Changing his zocor really complicated & compromised things further.

Hubby also got a very bad case of roseacea and the Mayo Dr. assured us that it would go away in time after he was off the prednisone and it certainly did.

Suffice to say the darn prednisone wreaks havoc.

Hubby is still on a pain management program for the colitis but things are looking up and he is having better days so I am hoping that weaning of the pain meds will be starting soon. Even with those pain meds the joint pain was very debilitating as you are reporting.

It's easy for others to say hang in there and it will get better or should with time but every day you are in that kind of pain is very tough to deal with. As suggested above maybe your Dr can have you checked or tested to be sure it is not something else that needs additional treatment.

I hope it is the prednisone withdrawal and you start to feel better sooner than later.

As everyone here knows, prednisone is a potent anti inflammatory, that is why it is so beneficial to so many inflammatory based disease processes. But as luna said above, I think most everyone hates it because of its horrible side effects. It would make sense that some individuals coming off their prednisone would develop joint pain, I wonder if trying Haldi drinks would give you relief as it is anti inflammatory?? They allowed me to come off all my UC and GERD meds and I have now been in remission for going on 2 years. The other option may be going on other pain meds, or back on steroids, good luck and I hope you find the right treatment to help you.

--------------------------------------------------------

yuckygut

diagnosed 1998

now off prednisone and colazal

drink 1 Haldi daily

my last pred taper, I had severe pain @ 5mg in my feet and knees, very hard for me to walk and climb stairs but once I got going would be ok. I just got down to 10mg again and am not looking forward to the pain again.

My blood tests all came back normal--no rhuematoid arthritis.  My joint pain has finally started to lessen during the past two weeks.  I definitely think my body is still adjusting to going off of the Prednisone.  In my experience, the longer I have to take Pred, the longer the side effects take to subside after going off of it.  Excercise, believe it or not, has helped the joint pain tremendously.  Hopefully you will feel better soon--hang in there!

I had horrible horrible horrible joint pain during the prednisone taper process in my shoulder, toes, hips, etc etc. Luckily it all went away albeit slowly after I got better and got off the prednisone. Hopefully, you'll get better too once you're in a good remission and get off the prednisone. 10 months at that dose seems like a long time with such a powerful drug, (although) i'm sure it helped your symptoms. I think you'll improve if you can get healthy. It's most likely the pred and you will get better and make it to your goal so keep your head up and keep pushing yourself to get out of bed each day and stay with your routine.

Hello, Everyone,

I too had horrible joint pain for 8 weeks after quitting prednisone. Prior to that I had to be taken off of Imuran because I came in contact with the shingles virus. During that time being off Pred and imuran my joint pain was unbearable.  I am now back on Imuran after receiving the shingle virus vaccine. This has just been a few days ago, so the Imuran has not had time to get in my system. As for the point pain now it is amazing, after being put back on predisone 20 mg a day until the imuan takes hold, my joint pain is absolutly gone. I ask my GI about that, because i came back from looking like an invalid to a healthy normal person.  My GI told me that my joint pain was not due to the predisone, but due to the disease and that was just part of it especially if you are in a flair. Sometimes he says it is a signal that you are going into a flair or you are in one.  All I know when I am not in a flair, I do not have joint pain. It's amazing how this disease affect people differently. God Bless you All.

Current meds: Imuran 20 mg, Colazal 3- 3X a day, Canassa 1 a day, Rowasa - nightly

Prednisone 20Mg (until Imuran kicks in)

Banjonut said...

I am in remission from Crohns and have changed my meds over the past 2 months.  It has caused me severe and disabling joint pain.  I simply cannot function without pain medication.  All of my joints from my toes, feet, ankles, knees, hips, shoulders, elbows, wrists and fingers are affected!  My Gas. Dr told me that he didn't think it was the withdrawal from prednisone or continued use of Imuran that was causing the problem based on the fact that he had never seen anyone with symptoms as severe as mine from either of those.

Personally, at first I thought it might be a side effect of the Imuran that I continued to take after the Prednisone.  (I have been off Prednisone for 6 weeks after being on 30mg/day for 10 months.)  I thought the prednisone was simply hiding the side effects of the Imuran.  So with my Dr's instructions, we stopped the Imuran a week ago to see if the joint pain would stop.  It has not stopped.

Now I am wondering if my joint pain is being caused by withdrawal from the Prednisone and not the Imuran.

I am 57 and was only diagnosed with Crohns 2 years ago.  I want to continue working until I am 62, but I don't think I can make it if this joint pain continues.  I have to take a vicodin every four hours and even then it hurts to walk or get in/out of a chair.  Without a pain pill I have to stay in bed and bear the pain even then.

Has anyone else experienced anything like this?  The only other drug I am taking is Asacol.  But, I have been taking that since the onset of Crohns two years ago and it never seemed to give me any problems.  Which most likely to be causing my joint pain, the prednisone withdrawal or the use of Imuran without the Prednisone?

The Banjonut

Banjonut - My GI put me on Prednisone for two months while at the same time on Imuran.  As soon as I stopped the Prednisone I noticed my joints hurt more than ever but assumed it was because the Prednisone made me feel better and helped my arthritis.  After continuing on the Imuran for two more months and having increasing joint pain, muscle weakness and swelling of my legs and feet (primary doctor gave me water pills for that) my GI doctor told me to quit the Imuran.  Now I'm just on Colazal 3 x 3 a day and Ultram 3 x day.  The Imuran helped the ulcerative colitis but my side effects are three of the "rare" side effects of this drug and I will not be able to take it. 

I still have lots of joint pain like you describe and to the point of tears.  I am thinking that it will take at least four months for the Imuran to clear my system since that's how long I have been on it.  I don't see my GI doctor until the end of November and just pray that things will get better as the Imuran leaves my system.  I really don't think the problem is with the Prednisone withdrawal but with the Imuran. 

Jayhawk

I don't know whether or not Imuran could be contributing to the joint pain. I've never taken the medicine.

However, I do know that tapering off pred can result in joint pain. I got horrible joint pain when I tapered off of it. For the first time in my life, I got a glimpse of what it feels like to have arthritis. It was not pleasant.

The body needs time to increase its natural production of cortisol during the tapering process. The result is inflammation. The inflammation in your colon can get worse, and you might also experience inflammation elsewhere, such as in the joints.

Tapering slower should help reduce the joint pain.

Here's a tip for alleviating some of the joint pain ... I have had UC for 14 years... done all the drugs ... was in remission for almost three years till I got recurring staph from a spider bite while at my kid's baseball tournament. Currently in hell tapering off prednisone again (UC under control after 5 months though). Down to 20mg from 70 mg. I go down in 2.5mg increments. This is one of the worst flareups ever. The joint pain in my legs became debilitating when I got under 30mg to the point I was unable to walk and had to crawl to get to the bathroom, or wherever. I didn't know if it was joint or muscle as my gastro said it could be proximal myopathy. Anyways - I coach a lot of sports and have tried to stay on top physical therapy trends. I was absolutley dying in pain and decided to wrap my legs and knees with tight wraps and voila, much of the pain went away. I had my wife run to the store and get a neoprene knee brace and instantly I was able to walk again, pain levels not totally gone, but down at least 70%. Then it moved to my hips, ribs, shoulders, elbows and arms. Again the wraps worked extraordinarily well in reducing the pain, that coupled with massage from my wife at least once a day. I have found that compression socks and leggings work very well for reducing the joint and muscle pain in the legs, they are not cheap, but well worth the investment. For the hips ... the old pro football player trick works well ... get some control top pantyhose a size or two too small and cut them off above the knees .. again works wonders. Shoulders are tough because you need a wide ACE bandage and have to have someone wrap it right, but again it works.

Post Edited (Tigerdan) : 3/15/2011 11:38:02 AM (GMT-6)

Hi Banjonut,

I got off pred in June 2011, every time I got down to 5mg, I would have horrible joint paint, even in the soles of my feet. I could only walk down stairs one at a time (I am 36). I was also on lipitor and since being off of pred it took a few months for me to feel better, once I got off lipitor I felt even better. I have been doing strength training since Oct 2011 and it has helped me tremendously!!!!!!!!!!!!!! I am so sorry you are going through this.

All my best,
Beth