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Better to be in some pain or better to up the dose of prednisone?
Polymyalgia Rheumatica (PMR) | Last Active: Aug 21 12:56pm | Replies (80)Comment receiving replies
You seem to know a lot about prednisone tapering and flares, so I thought I'd ask you. If I don't spot a flare and remain on my current dosage, reducing 1mg within the 4-8 weeks, will this hurt me? I ask because I am very active and often have pain. I'm a runner of 52 years, but have reduced my running to 3-4 times a week. The days I don't run, I walk. I also lift 4 days a week (lighter weights but hopefully will help prevent bone loss) and babysit a 19-month old who I pick up all day long, so I never know if the pain is overuse or PMR. I am down to 7mg and don't want to increase. I have some pain in the mornings again, but I can take a lot of pain as long as I can function. So.....thoughts?
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Do you keep a daily note of your pain level? @johnbishop recommends keeping a log of daily pain levels from 1 to 10, and I have found that useful. It could show you whether the activities you do are the likely cause or if a reduction has prompted it. If the pain is not getting worse, it may not be a flare.
With my flare last year, the pain level increased very gradually over a number of weeks, starting when I reduced to 6.5mg and increasing further after I reduced to 6mg, at which time pain was 5-6/10. A blood test confirmed inflammation had risen. Do you have regular blood tests to check your inflammation levels?
Have you tried splitting your dose and taking a small amount of the daily dose with dinner? That has kept many of us painfree in the mornings. I occasionally have aches and stiffness (not even 1/10) in the morning after overdoing activity or following a reduction, but it always passes.
You're doing well to be keeping so active. As you say, it helps bones and is recommended for anyone with PMR - as much as we're able without overdoing it.