I think Dr treating PMR have a pretty tough job. They disease requires long term steroid use.(>two weeks). Its also about the only thing right now that works over night. They try to do some due diligence to make sure its not something else. But they know when they start you on the prednisone it will work over night and you most likely will not be able to taper off. Most testing for how your cortisol is doing requires you be on less than 4mg of prednisone. By then most everyone is having a flare and its almost impossible to reliably test. The patient becomes its own worst enemy. Dr's just try to make it work. I know of no other drug right now that can treat inflammation for PMR as well as corticosteroids. All the things you mentioned are great and yes we should be doing them but how many of us do. The steroid replaces our bodies cortisol. The body has plenty to fight inflammation with this increase in prednisone. Its when you start to taper off the prednisone then you run short because your adrenal system has shut down. All the drugs you mentioned and Cushing's disease are over produced cortisol. Our problem is our bodies have shutdown production or adrenal insufficiency. I know of no other drug that replaces cortisol in our body other than corticosteroids.