Prednisone vs No Prednisone

Posted by kerrywp @kerrywp, Jun 12 12:31pm

Hello All,
After 3years of remission I am having a PMR flare. My pain is definitely uncomfortable but wondering if taking prednisone actually shortens the flare time - or does it just strictly help with pain relief? If pain is tolerable (but still painful) wondering if it would be more beneficial to not take prednisone.
And wondering if you don't take prednisone - does the pain/inflammation have its own negative impact?
Thanks!!
Kerry

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

kerrywp | @kerrywp | Jun 13 4:06pm

This is my exact question!! Thanks for stating is so clearly.

tweetypie13 | @tweetypie13 | Jun 14 9:42am

In reply to @kerrywp "This is my exact question!! Thanks for stating is so clearly." + (show)

My Rehumy out me onto Tylenol for Arthritis….works good

Teri | @tsc | Jun 15 1:04pm

Here's some information from perplexity.ai:

For polymyalgia rheumatica (PMR), standard pain relievers like Tylenol (acetaminophen) are generally not effective for controlling the underlying inflammation and symptoms of the disease. The mainstay and most effective treatment for PMR is a low-dose corticosteroid, typically prednisone, which rapidly relieves pain and stiffness by reducing inflammation.
Tylenol may be recommended to help with pain during the process of tapering down the steroid dose, but it does not address the inflammatory cause of PMR and is not considered a primary treatment. Similarly, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen have limited effectiveness; while rare cases have shown some benefit, especially when started early, they are not standard therapy and are generally much less effective than corticosteroids for PMR.
In summary:
Prednisone (or another corticosteroid) is necessary to control PMR in almost all cases.
Tylenol may help with pain but does not control the disease itself.
Do not rely on Tylenol alone for PMR; consult your doctor for appropriate corticosteroid therapy.

If PMR is left untreated, ongoing inflammation can significantly impact quality of life, increase the risk of vascular complications, and, in rare cases, cause permanent muscle or joint problems. However, with appropriate treatment, most people recover without lasting effects.

General Health Impact: Chronic inflammation can cause fatigue, weight loss, low-grade fever, anemia, and a general sense of feeling unwell. Mental health may also be affected, with increased risk of depression and emotional distress.

kerrywp | @kerrywp | Jun 15 3:15pm

In reply to @tsc "Here's some information from perplexity.ai: For polymyalgia rheumatica (PMR), standard pain relievers like Tylenol (acetaminophen) are..." + (show)

Very helpful. With my PMR back - I am now on 10 mg prednisone. Takes away most of the pain. Will discuss w primary doc next week - okay to have some pain that is tolerable? Or is more prednisone required to eliminate pain.
I kind of think if it is just moderate pain that comes and goes - okay to just stay on 10 mg - and then taper when we come to that point.
Thanks for the info!!!

chpfireball | @chpfireball | Jun 15 6:47pm

In reply to @mimi1204 "I’m wondering that too. I’m wondering if anyone handled their PMR flare without taking any prednisone?..." + (show)

I was on Prednisone for 18 mo and reduced 1mg per month to zero. After 22 days I started having problens with swelling in my hands and it got to the point I couldn't make a fist. My grip strength was 20. I'm 61 and normal is 20 to 30 for my age. I could pick up a coffee cup with one hand. Rheumatologist had me take Meloxicam for a month and it didn't change anything. Tested negative for RA. She put me back on Prednisone 10 mg and the swelling and pain completely went away. My grip strength is at 60 now. After 45 days I'm down to 5 mg Prednison and still doing fine.

grumpa | @grumpa | Jun 16 2:51pm

In reply to @seniormed "I would like to know lab results of my inflammation markers. If they are elevated indicating..." + (show)

I’ve read In some cases inflammation markers lag behind symptoms and a flare can get away

kerrywp | @kerrywp | Jun 18 10:33am

Had a relapse after three years off meds.
Been on 10mg prednisone for a little over a week. No pain.
Now starting my taper plan -
7.5 mg for 1 week. then
5 mg for 3 weeks then
2.5 mg for 3 weeks.
Will see how it goes. If pain comes back will start over then taper much more slowly.

Justin McClanahan, Moderator | @JustinMcClanahan | Jul 3 10:43am

In reply to @kerrywp "Had a relapse after three years off meds. Been on 10mg prednisone for a little over..." + (show)

@kerrwp,

I combined your discussion on tapering off prednisone to your previous discussion titled:

"Prednisone vs No Prednisone"
- https://connect.mayoclinic.org/discussion/prednisone-vs-no-prednisone/

Here, members can see your update and offer their experiences with tapering off prednisone and life on it vs. off of it.

rickman | @rickman | Jul 4 1:28pm

Wow that toally sucks.
Can you attribute it to anything like exercise or food.

I am only 3 months @ @.15 mg, hoping one day I wake up with no pain. However when I try to taper to .10mg, the pain comes roaring back in both shoulders and both areas of the groin.

On a side note, from my personal experiences (TRUE & MAYBE)
1. Avoiding red meat and fried food - TRUE
2. Ground (walking on earth) - Maybe, I suppose whatever makes you feel better is good.
3. Consuming (Turmeric, Ginger, Honey, and so on... - Maybe, I suppose whatever makes you feel better is good.
4. Drink lots of water - TRUE
5. Avoid stress, heat, and exertion - TRUE

kerrywp | @kerrywp | Jul 4 2:23pm

My 9 day taper didn't work so starting again and will do a ver y slow taper. Was on 10mg, tapered down to 7 and will stay here for a few weeks and then decide what is next. Unfortunately no set tapering plans since it seems so individualized.