Prednisone vs No Prednisone

Posted by kerrywp @kerrywp, 4 days ago

Hello All,
After 3years of remission I am having a PMR flare. My pain is definitely uncomfortable but wondering if taking prednisone actually shortens the flare time - or does it just strictly help with pain relief? If pain is tolerable (but still painful) wondering if it would be more beneficial to not take prednisone.
And wondering if you don't take prednisone - does the pain/inflammation have its own negative impact?
Thanks!!
Kerry

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

This is my exact question!! Thanks for stating is so clearly.

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@kerrywp

This is my exact question!! Thanks for stating is so clearly.

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My Rehumy out me onto Tylenol for Arthritis….works good

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Here's some information from perplexity.ai:

For polymyalgia rheumatica (PMR), standard pain relievers like Tylenol (acetaminophen) are generally not effective for controlling the underlying inflammation and symptoms of the disease. The mainstay and most effective treatment for PMR is a low-dose corticosteroid, typically prednisone, which rapidly relieves pain and stiffness by reducing inflammation.
Tylenol may be recommended to help with pain during the process of tapering down the steroid dose, but it does not address the inflammatory cause of PMR and is not considered a primary treatment. Similarly, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen have limited effectiveness; while rare cases have shown some benefit, especially when started early, they are not standard therapy and are generally much less effective than corticosteroids for PMR.
In summary:
Prednisone (or another corticosteroid) is necessary to control PMR in almost all cases.
Tylenol may help with pain but does not control the disease itself.
Do not rely on Tylenol alone for PMR; consult your doctor for appropriate corticosteroid therapy.

If PMR is left untreated, ongoing inflammation can significantly impact quality of life, increase the risk of vascular complications, and, in rare cases, cause permanent muscle or joint problems. However, with appropriate treatment, most people recover without lasting effects.

General Health Impact: Chronic inflammation can cause fatigue, weight loss, low-grade fever, anemia, and a general sense of feeling unwell. Mental health may also be affected, with increased risk of depression and emotional distress.

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@tsc

Here's some information from perplexity.ai:

For polymyalgia rheumatica (PMR), standard pain relievers like Tylenol (acetaminophen) are generally not effective for controlling the underlying inflammation and symptoms of the disease. The mainstay and most effective treatment for PMR is a low-dose corticosteroid, typically prednisone, which rapidly relieves pain and stiffness by reducing inflammation.
Tylenol may be recommended to help with pain during the process of tapering down the steroid dose, but it does not address the inflammatory cause of PMR and is not considered a primary treatment. Similarly, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen have limited effectiveness; while rare cases have shown some benefit, especially when started early, they are not standard therapy and are generally much less effective than corticosteroids for PMR.
In summary:
Prednisone (or another corticosteroid) is necessary to control PMR in almost all cases.
Tylenol may help with pain but does not control the disease itself.
Do not rely on Tylenol alone for PMR; consult your doctor for appropriate corticosteroid therapy.

If PMR is left untreated, ongoing inflammation can significantly impact quality of life, increase the risk of vascular complications, and, in rare cases, cause permanent muscle or joint problems. However, with appropriate treatment, most people recover without lasting effects.

General Health Impact: Chronic inflammation can cause fatigue, weight loss, low-grade fever, anemia, and a general sense of feeling unwell. Mental health may also be affected, with increased risk of depression and emotional distress.

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Very helpful. With my PMR back - I am now on 10 mg prednisone. Takes away most of the pain. Will discuss w primary doc next week - okay to have some pain that is tolerable? Or is more prednisone required to eliminate pain.
I kind of think if it is just moderate pain that comes and goes - okay to just stay on 10 mg - and then taper when we come to that point.
Thanks for the info!!!

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@mimi1204

I’m wondering that too. I’m wondering if anyone handled their PMR flare without taking any prednisone? I really don’t ever want to go back on prednisone, and I’m thinking that if the flare isn’t that bad and I can handle the pain should I do it without any help. Curious as if anyone has ever tried this.

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I was on Prednisone for 18 mo and reduced 1mg per month to zero. After 22 days I started having problens with swelling in my hands and it got to the point I couldn't make a fist. My grip strength was 20. I'm 61 and normal is 20 to 30 for my age. I could pick up a coffee cup with one hand. Rheumatologist had me take Meloxicam for a month and it didn't change anything. Tested negative for RA. She put me back on Prednisone 10 mg and the swelling and pain completely went away. My grip strength is at 60 now. After 45 days I'm down to 5 mg Prednison and still doing fine.

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@seniormed

I would like to know lab results of my inflammation markers. If they
are elevated indicating systemic involvement I would consider prednisone
if my earlier experience had no severe side effects. Systemic inflammation
increases our cardiovascular risks or inflammaging of our body. Consider
the Mediterranean diet and prescription alternatives as well.

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I’ve read In some cases inflammation markers lag behind symptoms and a flare can get away

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