Prednisone Taper

@rnm, One thing I would suggest that my rheumatologist told me when I was first diagnosed with PMR was to keep a daily log of my level of pain when I woke up and my dose of prednisone for the day. That helped with my tapering schedule. We are all different with our levels of pain and what is acceptable, for me it was anything at 2 or less on a scale of 0 to 10. There are many different discussions on Connect about tapering and managing symptoms. It really boils down to a discussion started by @dadcue that has a couple of good references to explain more about tapering off of prednisone:
-- How to Slowly and Safely Taper Off Prednisone but ... no set rules.
https://connect.mayoclinic.org/discussion/how-to-slowly-and-safely-taper-off-prednisone-but-no-set-rules/
Here's a search link that lists the many other discussions on tapering off of prednisone. It might be helpful to scan through them to learn what others have shared - https://connect.mayoclinic.org/search/discussions/?search=tapering%20off%20prednisone.

I have several comments about your post. 10 mg is a low starting dose for PMR. My understanding is that the normal starting dose is between 15 and 25 mg, but some websites say the dose can start as low as 8 mg. Is the 10 mg dose controlling your PMR? Are you pain free?

If you do a web search on how long people with PMR stay on prednisone, the results indicate 1-2 years is the normal course. Some people take longer, and some people never get off of prednisone. 2 weeks seems like a really short period of time before starting to taper. I have PMR and GCA, and I was on the starting dose of 60 mg a day of prednisone for 6 weeks before starting to taper.

To me it seems pretty risky to start tapering so soon.

I’m wondering if there are any other medical conditions
in your history that would mitigate against a higher dose
of prednisone. Did you respond overnight.? Low body
weight.? Minimal lab evidence? Labile diabetes?
A standard therapy trial is 15 to 25 milligrams and then
begin slow tapering after a few weeks of symptom control. How did your problem evolve.? Are your doctors
in agreement with the diagnosis? You may need to establish rapport with the primary physician who is accessible in the day to day management of your symptoms.

First of all, I weigh only 102 lbs. so that may be part of the reason my dose seems on the lower side. Secondly, the pain I had after initial dx was 8-9, but has subsided greatly since beginning the prednisone. By mid day I feel much better, minor pain only. Hope this helps.

It sounds like you might need a higher dose if your pain isn't controlled in the early morning. I've been receiving treatment for GCA and PMR for about 8 months, and I haven't had any pain in all that time. I'm currently at 8 mg prednisone, and I also take Actemra for the GCA.

Prednisone doesn't cure the PMR, it only controls the inflammation. People with PMR need to take prednisone until the PMR burns itself out or they start taking another drug like Kevzara or Methotrexate to control the inflammation that causes pain. I would be concerned about tapering too much too soon and letting the inflammation start affecting you again.

Slow taper is the right plan. Keep your internist posted and and consider
a slight dose increase if you are not comfortable. Monitor your BP
and take vitamin D3 with calcium. I always take prednisone with a meal
and Rolaids or Pepcid at night. Keep moving and be proactive. You should
do well.

I would ask the doctors if your goal is to be 'pain free' before starting to taper.
Keep moving, 'motion is lotion', but don't overdo

I started on 20mg of steroids. I was on 20mg for one week and tapered to 10mg. I only had slight pain as you have at 10mg. The idea is that you should quickly find your lowest possible dose. I tried several times over the next 5 months to reduce my dosage and was unable to reduce due to increased pain. I would go back to the 10mg. On the 6 month I was able to drop to 5mg with only slight pain. I then went to 2.5mg and then to zero. I did this over a 1 month period. I felt lucky that my PMR was apparently burned out. I was also lucky my adrenals started right up. This 6 month period I changed my diet and kept exercising. I was also seeing a rheumatologist at Mayo clinic. He never suggested I taper. He explained what steroids can do to you and let me navigate my taper. I would say your pretty close to on track. If you want to try and taper a little and see if your at your lowest possible dose then no harm in trying. Then every few weeks try again. The sooner you are off steroids the better. It has many side effects.

I tapered down from 20mg to .5mg in a year by doing it .5mg at a time, SLOWLY. I think that kept me from having any flares. It was a long process, but it also kept my pain at a tolerable level. I hope to be completely through with Prednisone in a week!

I started on 20, which did nothing. After 4 days, my rheumy upped it to 30, which still took 3 more days to suppress the pain completely. At that point my SED was 75. I remained on 30 for 4 weeks, then dropped to 10 over the course of 2 months, all pain-free. At that point, my SED was almost normal, my rheumy declared my PMR to be in remission and was no longer being treated with P. The task then was to safely taper, from 10 to 5 at 1 per month, then by 0.5 to zero, which I will achieve in a few days. Had my share of aches and pains during the long taper, but no PMR. All pain is not PMR. There are other conditions that can cause pain that were previously masked by your cortisol production.
You need to get the PMR into remission as measured by SED/CRP levels before starting to taper. Otherwise you are going to have a long and difficult experience. Best of luck. There is that too!!