Anyone have discomfort or pain when tapering off prednisone?

Posted by monami @monami, Apr 7, 2022

I am currently on a 3 dose of prednisone. I have some shoulder discomfort that goes down my back on either side. The left side is worse than the right. Anyone else experience back issues? It tends to go away by 3 or 4 pm. Thanks to all! We will get over this thing!

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@farnhamlaf1

I started at 30 went down to 25 went down to 20 went down to 1512.5 and then 10 I’m gonna try your advice so I take the 10 mg tablet and cut it into thirds?

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So did you skip 15mg? If so, that's a very large drop and steroid withdrawal pain might be catching up with you. Did your doctor give you a reduction schedule?

You really need a prescription for smaller dose tablets, 5mg and 1mg, to keep the dosages accurate, especially important from 10mg and below. I wouldn't attempt to split a 10mg tablet 3 ways. It's not accurate and accuracy matters as you reduce.

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@farnhamlaf1

I started at 30 went down to 25 went down to 20 went down to 1512.5 and then 10 I’m gonna try your advice so I take the 10 mg tablet and cut it into thirds?

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Those dosage-decrease increments would probably not by themselves be causing problems, but it would be helpful if you could also tell us about how long you were on each dose. Good luck.

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@art43

Those dosage-decrease increments would probably not by themselves be causing problems, but it would be helpful if you could also tell us about how long you were on each dose. Good luck.

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30mg 2 weeks 25mg 2 weeks 20mg 2weeks 15 mg 2 weeks and12.5 mg 5 days back to 15 for another week then back to 12.5 2 1/2 weeks now 10mg 2weeks so far

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@farnhamlaf1

30mg 2 weeks 25mg 2 weeks 20mg 2weeks 15 mg 2 weeks and12.5 mg 5 days back to 15 for another week then back to 12.5 2 1/2 weeks now 10mg 2weeks so far

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Very interesting. That is almost the exact schedule that I successfully followed, but I was never tempted to increase the dose while tapering.
There will be pain while tapering, but remember that it is not necessarily PMR pain, and therefore should not be automatically treated with an increase in prednisone.
Starting at 10, my rheumy declared that my PMR was successfully suppressed based on SED and CRP and pain types and levels, and that my pains were not PMR. I then continued to taper at 1 per month to 5. During that period, I had intermittent random pains and cramps that were treated with Tylenol. Note that one should NOT take both prednisone and NSAIDS (e.g., ibuprofen or naproxen) unless your doc specifically asks you to. Combined, they can cause serious even fatal perforations of the digestive system.
Then, from 5 to 0, I tapered at 0.5 per month. Again, random minor non-PMR pains that probably represented issues like osteoarthritis that had been suppressed by my normal cortisol production which had not yet been completely restored. Below 3, my doc approved an occasional low-dose ibuprofen with prilosec if needed.
Now I have been off prednisone for just over two months. At the age of 82, no pains worth mentioning, and no pain meds. Apparently a successful course of treatment over 18 months.
One plan does not usually work for everyone, but it helps to understand the safe options and the biological processes in play in order to respond successfully. Best of luck to you.

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@megz

How much did you drop by to get to 10mg? A fairly large drop can cause new pain/stiffness. Is the pain and stiffness only in the morning or all day? If it's mainly in the morning, a split dose might help.

Everyone who splits their dose to control morning pain seems to do it a bit differently. Most of the dose is best taken in the morning when the body would normally produce cortisol. From the advice I found on split doses before doing it myself, no more than one third of the dose should be taken later in the day, and not so much in the later dose that sleep is affected.

When I was up around the dose you're taking I took most of the pred in the morning and 2mg with dinner and it controlled morning pain. Currently I'm down to 4mg, taken as 3mg morning & 1mg with dinner and there is no pain, just occasional morning stiffness or slight aches which pass.

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Thank you. That sounds pretty reasonable. I’ll try that too.

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@art43

Very interesting. That is almost the exact schedule that I successfully followed, but I was never tempted to increase the dose while tapering.
There will be pain while tapering, but remember that it is not necessarily PMR pain, and therefore should not be automatically treated with an increase in prednisone.
Starting at 10, my rheumy declared that my PMR was successfully suppressed based on SED and CRP and pain types and levels, and that my pains were not PMR. I then continued to taper at 1 per month to 5. During that period, I had intermittent random pains and cramps that were treated with Tylenol. Note that one should NOT take both prednisone and NSAIDS (e.g., ibuprofen or naproxen) unless your doc specifically asks you to. Combined, they can cause serious even fatal perforations of the digestive system.
Then, from 5 to 0, I tapered at 0.5 per month. Again, random minor non-PMR pains that probably represented issues like osteoarthritis that had been suppressed by my normal cortisol production which had not yet been completely restored. Below 3, my doc approved an occasional low-dose ibuprofen with prilosec if needed.
Now I have been off prednisone for just over two months. At the age of 82, no pains worth mentioning, and no pain meds. Apparently a successful course of treatment over 18 months.
One plan does not usually work for everyone, but it helps to understand the safe options and the biological processes in play in order to respond successfully. Best of luck to you.

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Thank you for sharing

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@art43

Very interesting. That is almost the exact schedule that I successfully followed, but I was never tempted to increase the dose while tapering.
There will be pain while tapering, but remember that it is not necessarily PMR pain, and therefore should not be automatically treated with an increase in prednisone.
Starting at 10, my rheumy declared that my PMR was successfully suppressed based on SED and CRP and pain types and levels, and that my pains were not PMR. I then continued to taper at 1 per month to 5. During that period, I had intermittent random pains and cramps that were treated with Tylenol. Note that one should NOT take both prednisone and NSAIDS (e.g., ibuprofen or naproxen) unless your doc specifically asks you to. Combined, they can cause serious even fatal perforations of the digestive system.
Then, from 5 to 0, I tapered at 0.5 per month. Again, random minor non-PMR pains that probably represented issues like osteoarthritis that had been suppressed by my normal cortisol production which had not yet been completely restored. Below 3, my doc approved an occasional low-dose ibuprofen with prilosec if needed.
Now I have been off prednisone for just over two months. At the age of 82, no pains worth mentioning, and no pain meds. Apparently a successful course of treatment over 18 months.
One plan does not usually work for everyone, but it helps to understand the safe options and the biological processes in play in order to respond successfully. Best of luck to you.

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Thank you for this post. I’m tapering and your comment “no pain with mentioning” jumped out at me. I had a few aches and immediately contacted my doctor who advised me to increase. I didn’t do it because the pains subsided and I decided to just monitor it for a couple more days. I’m glad I didn’t panic and up my dose. I’m hoping for the same result as you

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@art43

Very interesting. That is almost the exact schedule that I successfully followed, but I was never tempted to increase the dose while tapering.
There will be pain while tapering, but remember that it is not necessarily PMR pain, and therefore should not be automatically treated with an increase in prednisone.
Starting at 10, my rheumy declared that my PMR was successfully suppressed based on SED and CRP and pain types and levels, and that my pains were not PMR. I then continued to taper at 1 per month to 5. During that period, I had intermittent random pains and cramps that were treated with Tylenol. Note that one should NOT take both prednisone and NSAIDS (e.g., ibuprofen or naproxen) unless your doc specifically asks you to. Combined, they can cause serious even fatal perforations of the digestive system.
Then, from 5 to 0, I tapered at 0.5 per month. Again, random minor non-PMR pains that probably represented issues like osteoarthritis that had been suppressed by my normal cortisol production which had not yet been completely restored. Below 3, my doc approved an occasional low-dose ibuprofen with prilosec if needed.
Now I have been off prednisone for just over two months. At the age of 82, no pains worth mentioning, and no pain meds. Apparently a successful course of treatment over 18 months.
One plan does not usually work for everyone, but it helps to understand the safe options and the biological processes in play in order to respond successfully. Best of luck to you.

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This was exactly my experience. I have had hip girdle pain this past week that has subsided somewhat. Then I realized I also had a sore throat for the past week that is now gone. I'm thinking I may have had a mild infection. I keep a calendar of symptoms and drugs and will monitor more closely.

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