Normal response after 5 days on prednisone?

I recall complaining to my doctor after the first week or two of prednisone that I'd had only 70% improvement on 15mg start dose and hadn't had the immediate "miracle" pain reduction spoken about by many people. It takes time for prednisone to work fully for some of us. A month in and after splitting the dose to taking most in the morning and a smaller part of it (2mg) later with dinner resolved all the morning pain for me, 95% pain reduction with only minor morning joint stiffness. Sometimes it's not necessary to increase the prednisone dose, it can be just tweaking how we take it and waiting a bit for it to have a chance to reduce the inflammation and pain.

Great advise. Thank you. I will try that. My prednisone is 10mg pills. How did you split the pills for a 2mg dose? Quartered?
If I don’t have better results I think my doc plans on doing something else but we’re not going there just yet. She also sent me for X-rays (which I did) and a sono in the near future. Thinking I have something going on in one of those areas and not PMR? I do believe it’s PMR.
I think she mentioned taking prednisone after breakfast or lunch because of the side effects (sleeping which hasn’t been great) but trying a small dose after dinner is definitely worth a try. Again, thank you.

10mg pills won't let you adjust your dose accurately. You'd need smaller dose pills - they're necessary for when you start to reduce anyway. Can you get 1mg pills? I use only 5mg and 1mg tablets which makes it easy to split the dose and reduce by small increments. Always take prednisone with or after food or milk to protect the stomach.

Follow your doctor's advice rather than what you find here if you're not yet sure of the diagnosis. Let us know how your results go.

Hello @debbiebas216, I would like to add my welcome to Connect along with @megz and others. I was started at 20mg dose for both of my occurrences of PMR. I think the average starting dose is 12.5 to 20 mg but can be higher if the rheumatologist/doctor suspect GCA in addition to the PMR. You might consider asking your doctor to prescribe prednisone pills in the 10mg, 5mg, 2.5mg and 1mg. That makes it much easier when tapering your dosage when you start feeling better. Also, if you haven't started keeping a daily log with your level of pain when you first get up along with your dosage for the day, you might want to start one.

Some members have found it helpful to split their dose morning and evening or late afternoon. I always took mine first thing in the morning with my blood pressure meds and my PMR pain was gone within a few hours until the next morning.

Thank you. Being new at this, I have many concerns and questions and certainly appreciate and value the feedback.
I am keeping a diary.
Do you have pain in the morning before your meds? The doc was concerned that my pain level wasn’t already at
80-90% throughout the day (including mornings) after 5 days so that’s why she said try 20mg for 3 days after the 15mg didn’t seem to bring the effect she (and I) hoped for. I just wasn’t sure if my pain in the morning was “normal” (I take my meds around 8:00). My pain level was good after 12-1:00.
It’s a good suggestion re different med strengths. I will ask for other dosages but I think she wants to confirm PMR first?

When I was initially diagnosed with PMR at Mayo Rochester, my rheumatologist prescribed 20mg prednisone as my starting dose. My pain level at the time was about 7 to 9 on my scale of 0 to 10. The appointment was in the morning and also had a follow up with him at 3pm the same day. We picked up the prednisone at the pharmacy and I took my first dose at noon with lunch and by 3pm my pain was almost all gone (less than 1). I was still stiff and a little achy but so much better than in the morning. When I started tapering, if my level of pain was greater than a 2, I didn't taper and sometimes depending on the amount of pain, I increased the dose to half of my previous amount that I tapered down.

I understand the doctor wanting to confirm PMR since there are quite a few different conditions that mimic PMR and the quick way doctors diagnose PMR is seeing if you respond to a starting dose of prednisone (in my non medical opinion). Here's some more info on the conditions that mimic PMR - https://www.medicalnewstoday.com/articles/diseases-that-mimic-polymyalgia-rheumatica.

Great. Thank you. All info is greatly appreciated.

Thanks, I looked up your link was negative for other possible diseases that mimic PMR.
Very helpful.

Do not, do not, do not ever go playing around with your prednisone dosage without checking with your rheumatologist. I was diagnosed in Jan 12. On Oct 28th I took my last 1 mg pill. I still have minor pain but the side effects of prednisone were terrible. If you’re on 15 to,20 mgs, you should not have pain at all. I saw my rheumatologist once a month since January, now we will meet every 3 months.
I’m feeling so much better without the prednisone, almost normal for a 76 year old. Keep the faith, live your life, with a rheumatologist by your side.

I started on 20.
No improvement after 4 days, Testing ruled out non-PMR causes, so rheumy changed me to 30. Instant total relief.
Stayed on 30 for one month, then down 5 every two weeks to 10, then down by one every month to 5, then down 0.5 every month to present 2.
With testing, PMR was declared in remission at 10.
This has worked safely and effectively for me, but best if you can work with your own doc as there can be considerations other than PMR that influence treatment. Best of luck.