I have osteopenia ( less severe than osteoporosis) and my rheumatologist put me on Fosamax to prevent bone loss as soon as I started the prednisone. While on Fosamax my bone density increased 10%. You might talk to your doctor about whether this medication would be appropriate for you. Also, Kevzara is a newer medication for people who have PMR but cannot tolerate prednisone or cannot taper off it. As far as flares, my rheumatologist told me that I could increase my dose up to 25%, then taper back to where I was. My experience is that waiting to increase prednisone during a flare just makes it harder to get the pain under control. I reduced my previous activities ( uphill hiking, biking, yard work etc. ) . What I do now seems pretty whimpy but I stay active.

It seems like the chorus has all chimed in about the importance of a rheumatologist. I really hope you’re able to find someone. I know it’s usually a long wait, but they’re so much better positioned to help with the how it all fits together. Maybe you can see them once and after that if you need follow-up, you can do telehealth?

It can be dangerous or at least risky treating PMR without a specialist because of the symptoms, side effects to prednisone, etc.

It’s pretty common for people with PMR to need to supplement calcium and vitamin D, and/or start a medication preventatively for bone loss. My dad didn’t have osteoporosis, but because of his age, his rheumatologist started him on Fosomax as others have mentioned.

It may be worth asking your primary about that too if you’re not already covered by your treatment for osteoporosis.

Wishing you all the best.