treatment of PMR

If you had your baseline labs completed and the diagnosis is probable PMR then an appropriate dose
of prednisone is helpful in firming up the diagnosis.
The response to therapy is often within days.
If you don’t have any medical or metabolic reasons to
avoid treatment the side effects can be manageable.
Exercise as possible and vitamin D for osteoporosis
prevention . Have a DexaScan early on .Diet helps both the inflammation and BP and glucose. I had a cardiac risk evaluation and eye exam.
Turmeric, vitamin D, statins and stevia are in my diet
after remission. Melatonin is is proving to have anti-
inflammatory action as well.
Communication with your doctors is the most helpful
way to cope with any side effects.

thanks so much. Just know that those Steroids' have numerous side affects would prefer not to start . But if there is not other choice ...

steroids do have side effects. But so can the pain/inflammation you endure trying to not use them. Just educate yourself and realize that the steroids do not cure anything. They are strictly a treatment. Your body needs to cure the PMR. Steroids have an addictive effect making it almost impossible to taper off. I would google as much as you can about adrenal insufficiency with prednisone. Keep the dosage close to the pain level right from the start and continually keep bumping up next to the pain level. Then all the suggestions to help your body try to follow. Diet, exercise, no alcohol, stress reduction, etc. If you approach it with the thought this drug is not your friend and understand how it is affecting your body, PMR doesnt have to control you.

My PCP is starting me on Meloxicam this week for inflammation. It is a non-steroidal anti inflammatory. Doc described it as a little mallet as opposed to the big hammer of prednisone. He does not attribute my hand and knee pain to my PMR. Prednisone will be a very last resort. Handling the pain and stiffness with Tylenol extra strength and Volteran. Good Luck

Good luck. RA has been around a long time. Particularly the damage it does to hands and joints. I think Dr's tend to make that association first when in the hands. But hand and knee pain particularly are definitely part of PMR. I could not even close my fist. If you have the PMR markers and have been diagnosed with PMR then Meloxicam may not work. RA sufferers have many drugs to choose from. MTX , Humira, LDN, etc. Newer biologics might work. Corticosteroids appear to be all that works if the PMR becomes advanced. It was to hard for me. 4 hours later no pain at all.

"RA has been around a long time."

"Corticosteroids appear to be all that works if the PMR becomes advanced."
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I think the narrative that "prednisone is the only option" gets perpetuated because there hasn't been the research done for PMR like it has been done for RA. Promoting the fast response to prednisone as a "miracle" while the long term side effects of prednisone are downplayed or "easy to manage" doesn't promote the pressing need for more research into PMR. For some reason, the lessons learned from RA aren't applied to PMR.

My PMR became refractory. I didn't ever think prednisone worked that well based on the number of relapses I had. I believe the long term use of prednisone actually perpetuates PMR. I think the immune system needs to be reset quickly and people need to taper off Prednisone as soon as possible. A sustained remission of PMR needs to happen sooner rather than later.

Prednisone worked well for uveitis and some other problems I had before PMR was diagnosed. A 60 mg dose for uveitis followed by a fast taper to achieve remission didn't cause many problems relative to the long term use of prednisone for PMR.

your exactly right: "Conclusions: Polymyalgia rheumatica remains a clinical enigma and its relationship to giant cell arteritis is no clearer now than it has been for the past 125 years. Diagnosing this disease is still almost exclusively dependent on the clinical acumen of a patient's medical attendant. Until an objective method of identifying it clearly in the clinical setting is available, uncovering the aetiology is still unlikely. Until then, clear guidelines on the future incidence and prevalence of polymyalgia rheumatica and the public health problems of the disease and its management, especially in relation to the use of long term corticosteroids, will be difficult to provide." https://pubmed.ncbi.nlm.nih.gov/25201886/

Meloxicam worked real well for me with a arthritis flare in my feet and ankles and I could not walk!!
Best wishes, I hope it works for you, too!

I was put on Meloxicam before I was diagnosed with PMR. In preparation to taking prednisone after diagnosis I quit taking the Meloxicam and was surprised at how much it had been helping with the pain. But the prednisone took me from nonfunctional to functional with few side effects. I do not regret it at all. Everyone needs to decide for themselves.

Thank you. Those who are saying they’re having no side effects from the prednisone don’t know what long term damage might be happening to their organs. Like higher chances of cancer. I have a precancerous condition and refuse to touch the stuff.