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Two things I want to address. I am definitely learning that PMR treatment and weaning is not an exact science. To address the question of doing your body harm by not taking prednisone I remember asking the rheumatologist exactly that and her comment was that the inflammation and harm to the body would not be in my best interest. She made the point with me when she mentioned it can lead to heart annd/or organ issues in long run. The second is I noticed that a post was in the string regarding NOT splitting dose of prednisone. When I asked rheumatologist at initial visit how to take my meds, I was told that taking all at once or splitting was really up to me and how it worked for my pain relief. To that answer I say that treating PMR is definitely “practicing medicine.
Replies to "Two things I want to address. I am definitely learning that PMR treatment and weaning is..."
Chronic inflammation is bad but so is chronic Prednisone use.
There are other ways to treat chronic inflammation besides Prednisone. Until relatively recent research, prednisone was considered to be the "only option" for PMR. The belief that Prednisone is the only option is changing if not totally debunked. Biologics are being tried for PMR. Now the research shows that certain biologics might be better options than long term prednisone for PMR.
The problem with "long term" prednisone use is that it suppresses adrenal function and creates a scenario where it is extremely hard to taper off prednisone. I'm not sure how long you can safely take Prednisone but the research shows more and more ... not very long.
https://www.drugs.com/medical-answers/long-you-prednisone-safely-3561220/
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In theory, PMR is a self limiting disease for a year or two and doesn't cause any lasting harm.
PMR is generally manageable and the outlook with treatment is often excellent, allowing most people to live normal, productive lives. However, relying on it to resolve on its own within a short time frame and without potential lasting complications like those associated with GCA or long-term steroid use is not accurate.
Sometimes I think treatment with long term prednisone creates perpetual PMR symptoms when we attempt to taper off Prednisone.
Thank you for the comment @jimp I sent a message to my doctor today and very curious if she will have a similar point. Will report back
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People with PMR also need to remember that 15-20 percent of people with PMR develop GCA, which, based on personal experience, you want to avoid if at all possible. GCA can cause vision loss, strokes, aneurysms, etc. Plus it requires a higher starting dose of prednisone and a long period of time above the starting dose needed for PMR.