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Sore Muscles & Prednisone

by
author image Sriram Ramgopal
Sriram Ramgopal is a medical graduate from Sri Ramachandra University, India. He currently lives in the the greater Boston area and works as a Neurology Research Fellow at Children's Hospital, Boston. Ramgopal is also the co-founder of Sangam India, a nonprofit urban development organization based in Chennai, India.
Sore Muscles & Prednisone
Steroid induced myopathies can affect the thighs, making it difficult to rise from a chair. Photo Credit Comstock/Comstock/Getty Images

Steroids, such as prednisone, have an important side effect in muscle deterioration. Associated with this are both acute and chronic steroid-induced myopathy. However, steroids also have powerful anti-inflammatory effects, and are therefore used in some autoimmune diseases that affect muscles. Thus, steroids are a double-edged sword: they can cause muscle pain, but may be useful in relieving some forms of it as well.

Chronic Steroid Myopathy

Steroids promote the breakdown of protein in muscles. Some individuals who take steroids for a long time can develop what is known as a muscle disease, or myopathy. Often, the proximal muscles, such as the muscles in the upper arms or the thighs are affected. Symptoms can occur after prolonged consumption of steroids and may occur within weeks to years after regular consumption. Patients often have weakness and an inability to perform activities such as rising from chairs, climbing stairs, or bringing their arms over their heads. The muscles of the chest, face feet and hands are usually not affected.

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Acute Steroid Myopathy

Acute steroid myopathy is relatively less frequent than the chronic form. It is also known as "intensive care myopathy." The disease typically occurs five to seven days following a high dose of steroids. The myopathy affects all four limbs, causing quadriplegia. In addition, it can also affect the muscles of breathing, leading to a dangerous breathlessness. Affected individuals may need a respiratory in the event of breathing difficulty. Fortunately, most patients with this form of muscle disease recover completely.

Dermatomyositis and Polymyositis

Dermatomyositis and polymyositis are autoimmune diseases that can both cause muscle weakness. The muscle weakness with these conditions is commony felt in the upper arms and thighs. This disease occurs more commonly in adults in their thirties. As with patients with chronic steroid-induced myopathy, patients with these diseases have difficulty rising from chairs and climbing stairs. Patients with dermatomyositis may also have a rash that appears on the eyelids and over the bony prominences of the hands. This condition is one that is treated well with steroid drugs, as the inflammation often subsides drastically. The steroid of choice is prednisone. Patients are usually given a high initial dose, which is gradually reduced.

Polymyalgia Rheumatica

Polymyalgia rheumatica is another disease which can be treated with steroids. Though this disease often causes pain in the muscles, the actually site of involvement is the joints. The disease usually occurs in individuals over 50 years of age. The pain is typically felt over the shoulders and neck; later it can involve the hips. In addition, patients complain of fatigue, loss of appetite and fever. Polymyalgia rheumatica is often treated with a low-dose of steroids to relieve the muscular pain. Treatment may be needed for two to six years. Patients with this condition should also be evaluated for giant cell arteritis, which can cause blindness if not treated promptly, because the arteritis is often associated with this condition.

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