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PMR and the taper
Hello , new to the group 65 years old
I was Diagnosed with PMR 12/28/24 and have been tapering down from 25 mg to 20 to 15 to 12.5 to 10 …about a week on 8 mg of prednisone and the pain is back was hoping it would be better… so my question is with each 1mg drop is the pain going to go away. ? I will not take a higher mg . The side effects from steroids are awful.the pain is awful Im getting discouraged 🫤 Any suggestions or advice, thank you
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My Dr has no idea of how to taper the prednisone. She can't even givec a diagnosis. Every lab work was negative. Is there a lab test for PMR . She says I don't have it, but all the symptoms point to it. Prednisone rid of the pain. I was on 20mg and then told to stop. Pain came right back by a week. Went to 20mg, then 15mg for a week then 10mg for a week, next is 8mg.
The ESR and CRP blood tests are usually good indicators of the inflammation associated with PMR, but it is possible to have PMR and normal values for those tests. According to google, imaging tests such as ultrasound, MRI, and PET/CT can be used to identify inflammation in soft tissue and joints which is characteristic of PMR. Those scans along with the symptoms can be used to diagnose PMR.
Can you get a second opinion, such as from a rheumatologist?
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2 ReactionsGlad you are here. Keep reading comments on this site. Lots of good information and support. Some bump back up a bit if pain is too much while others try to work through it.
Hello. I am new to the group, but have had PMR since May 2023. I joined the discussion because of a recent flare-up that has me a bit disappointed and looking for insight. I will up my dosage and keep reading.
Thank you
John
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1 ReactionWelcome to the group.
Flares are common when your Prednisone dose is lowered. Flares frequently happen when your dose gets to 7 mg. What dose of Prednisone are you taking?
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1 ReactionNew to the group diagnosed in January 2025. Started on 60mg worked my way down to 10 mg then it came back. Went back to 20mg, down to 15mg can handle the pain at this level but the side effect of the steroids. Started the Kevzara shot hopefully that helps. The biggest thing for me is that I was physically active and workout sometimes makes it worse with the fatigue and stiffness.
Welcome to the group. You'll find lots of great information here. My first reaction on reading your taper is that it sounds very fast to me. Just for comparison's sake, I was at 20 in January and now I'm down to 10. The taper does need to slow as you get lower, but yours seems like a fast dip. Have you been working with a rheumatologist? I highly recommend it.
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1 ReactionYes I have been working with a rheumatologist's. .
Do you have GCA or PMR or both?
Kevzara should allow you to get to a lower dose of prednisone than you would otherwise be able to do without Kevzara. I remember being on 60 mg of prednisone and not being able to taper down to 10 mg for 12 years despite tapering slowly.
A biologic similar to Kevzara allowed me to taper from 10 mg to 3 mg in a couple of months. I needed to stay on 3 mg of prednisone for 6 months to give my adrenals time to recover and start producing cortisol again. With time, my adrenals were able to produce more cortisol again so I was able to discontinue prednisone.
How rapidly your adrenals recover will mostly determine how quickly you can taper off prednisone. I think it is great that you started Kevzara so soon, With any luck Kevzara will keep your autoimmune condition under control. Kevzara won't suppress your adrenal function like Prednisone does.
Just PMR. Thanks for the info. Is there tests too show if your cortisol is back to producing enough?
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