Better to be in some pain or better to up the dose of prednisone?

I did the prednisone taper with Kevzara. I had had 9 doses (18 wks) with Kevzara when I stopped prednisone. I am now almost 3 wks off prednisone. My discomfort comes with high humidity/dew point totals of 80% or more in the AZ heat. I then take Tylenol for arthritis, 2 @ 2 or 3 times a day as needed. (Usually just at wake up and bedtime.) As needed translates to days I walk the golf course or do other strenuous activity outdoors. Today is 85% and an extreme heat warning. These flares are comfortably handled with the Tylenol for A. Good luck. All by trial and error and this fabulous blog.

I commenced on hydroxy 3 months ago 400mg and stopped pred however I am having a lot of pain in the morning that sometimes last and other times it eases in turmoil daily as you restart pred

Should I restart pred ??

Have you had blood tests to see if your inflammation is high? What does your doctor suggest?

I would like to respond; however, you have not provided enough information about your tapering process and withdrawal of prednisone to make reasonable recomendations.

From what I know it’s best to lower your inflammation rather than power through w pain. I had PMR - got Lyme not long after - and then had a flare of swelling in my hands w pain that I was told was PMR morphing into rheumatoid arthritis. But really do they actually know? My bloodwork does not reflect Rheum. Was it Lyme despite 30 days on antibiotics? They are guessing but they put me on Lefluminide( Arava) and tapered Pred and it’s working. Lefuminide is Methotrexate’s sister - not a biologic. I muscle tested Metho and I was weak. Lefluminide tested fine. I have no significant side effects and am essentially pain free. It’s very exciting but so worrisome this is a lifelong medicine. I just don’t want that. Now tapering down from the 5 mg Pred a day. This should be interesting. I would say to try to find pain relief but you may have to experiment. Chronic pain comes at a terrible price both mentally & physically. Inflammation exacerbates itself. I hope you can find relief.

I am having the same dilemma. I have been off prednisone since January. No pain for several months, but I'm now getting stiffness (gelling) in my neck and hips. But my arms and hands are great which they weren't with PMR. My numbers are up but not as high as they were before prednisone. The rheumy offered to put me on 2 mg of prednisone but I don't really want to. I'm actually pretty functional with ibuprofin helping. Tylenol never did anything for me. I am going to give it longer. If it doesn't get worse, I may just live with it.

I started at 25mg. in December and was going down once per month till two months ago, when I was told to go down by 1 mg every two weeks instead. Ten days ago, with no problems I went down from 8 mg to 7 mg. Now for the first time I am waking up with painful and stiff right wrist and arm nearly to shoulder, some pain in hips and between shoulder blades. I had acupuncture in the shoulder a week ago and all of the pain vanished for a week. Here is my question: The rheumy said to call him if I had a flare-up and we'd discuss going back to the higher dose. But I am unsure of what consists of a flare-up. How severe does the pain have to be to call it a flare-up? After I get up in the AM, have coffee, breakfast and do my chores, by 9 AM the pain is nearly all gone for the rest of the day. It stays away till about 9 PM before I can feel it creeping back. Would a flare-up also do this, or am I not gauging things the right way? So, its just that before I call him, and I will if I must, I really want to know more about how one would describe a flare-up, is it any creaks and pains when you've had none heretofore, from going down to the lower dose? Or is a flare -up defined as being as severe, or nearly as severe, as what you came in for in the first place? Anyone who can help me define this, I will be grateful. Thanks. I would rather live with some pain and reduced dosage than have to go back up again.

Flares are very hard to define. Many people get tripped up at that 7 mg dose of Prednisone. I suspect something else happens at 7 mg because pain returning at 7 mg is extremely common and can't be just a coincidence.

My first question would be whether the pain is similar or the same as your symptoms when you were first diagnosed? Typically the pain isn't the same in terms of location, severity, etc.

What I would consider a flare is when the pain is relatively the same. Flares might not be as severe at first but with time the pain gets worse and not better. Flares can usually be distinguished from prednisone withdrawal symptoms because flares get worse. Withdrawal symptoms tend to get better in a few days after a decrease in dose.

Some people would rather not live with any pain so they increase their dose and call it a flare. When I did that, my rheumatologist didn't care but she would rather that I let her know before I increased my dose.

When I didn't know if it is a flare or not ... I let my rheumatologist know via a short, concise and non urgent message. Typically, my rheumatologist would respond in a day or two and want my inflammation markers checked before I increased my dose.

From what I know your body creates 7.5 mg of cortisol through the adrenals. Once you hit 7 mg if your adrenals dont kick in- and they might well not - that’s the trip up. Sluggish adrenals make tapering tough. Maybe try something else to help w pain. I found tramadol w tylenol helpful for the short term.