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Better to be in some pain or better to up the dose of prednisone?
Polymyalgia Rheumatica (PMR) | Last Active: 2 days ago | Replies (36)Comment receiving replies
Good question. I’m asking myself the same thing. I’m in pain every morning but not in the afternoon or evening. I’m presently on 5mg prednisone and want off asap. I started hydroxy… but hasn’t kicked in yet and it’s been about 9 days. I plan on tapering 1mg every 2 weeks and see how that goes. May try 5 one day and 4 the next but haven’t had relief since I was on 10mg but will not go up. It that a mistake? I don’t know. I’m finding the weather has an effect-rainy days (lower barometric pressure) take a toll. Good luck and I hope you can find an answer. If I figure it out, I’ll share.
Replies to "Good question. I’m asking myself the same thing. I’m in pain every morning but not in..."
Unless it is determined that your PMR is in remission (typically determined by/confirmed with SED/CRP testing), continuing to taper is almost guaranteed to result in ongoing PMR pain.
One usually stays on a dose that completely controls PMR pain until the inflammatory tests return to normal levels. For you, that dose might have been 10, and you might have started tapering prematurely, before your PMR was in remission. Or, in your haste to get off of prednisone, you tapered too quickly. Or, you are tapering without waiting to determine if hydroxy is going to work. Below 10, tapering at 1 per month seems to work for most folks. Below5, at 0.5 per month. But all that presumes that your PMR is in remission.
Good luck.
Debbie - Everyone feels pain differently, so ultimately, you will find the treatment solution that best suits your goals. None of it is easy - prednisone 15 mg. gave me immediate relief and I able to resume activity. Then the rheumo prescribed hydroxy at 200mg. twice a day, with a long prednisone taper. Tinnitus and depression set in. While Lexapro treated the mood disorder, I wanted off all meds completely. I toughed it out for 2 months, dealing with pain through meditation, stretching and tylenol. But now I am back on prednisone which has given me pain and mental relief. It's a journey with no one answer. Just hang in there - this thread is helpful for its kindness, shared experience and compassion.
I suggest only a half mg/month. If you still have PMR and you drop too fast you risk the possibility of a major flare. It depends how your flares present. Mine I can barely get out of a chair. I started KEVZARA in December.
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Wow......the weather is something I've thought caused a lot of my bad days! I'm not seeing my rheumatologist till end of May, I'm taking it a day at a time.....seeing how I feel at 10 day on 15mg of prednisone......my pain level, without Tylenol or just 1 a day. Then will try to start cutting back! I had a day Tuesday.....so not sure how it will go!
Do you know what your CRP level was on your blood work? My last flare in Oct, it came down fairly fast.....2-3 weeks. But I'm don't sure this time......this was like hitting a brick wall!