How to address PMR pain while decreasing prednisone

Posted by barbararene @barbararene, Feb 13, 2017

I have been diagnosed w poly myalgia rheumatica (pmr). Am taking 5 mg of predisone, was taking 10mg.
Every time I go on a low dose, symptoms come back. I can't take pain meds, but do drink wine to ease pain, although I'm told no alcohol w prednisone. Anything you can share as far as info

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

@charlena

My husband is still on prednisone, it's been nearly 2 years. He has tried several times to decrease, but has always had to go back to initial doseage.
He is again trying a reduced doseage. Do you mind telling us what your symptoms are?
At his last doctor visit as the doctor was going over his symptoms, etc. he made the statement, "..... polymylagia rheumatica, if that is what you have, . .. ." Needless to say, we weren't happy with that statement. Another of his doctors advises that my husband's symptoms are not like any symptoms of patients he sees that have polymyalgia rheumatica. I research daily on my husband's symptoms and when I mention to his rheumatologist he doesn't seem interested in other possibilities. Probably time for a new doctor.

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I haven't been writing lately but your story is so similar to my own. I am still on prednisone (4 mg) and have tried often to ween off of it, but can't. When I tried to go down to 3 mg, the pain came back with a vengence! I also take tramadol twice a day and am told I can use 3 times a day but don't. I also have gained so much weight and was overweight before I took it. When I try to lose some of the weight nothing works. I have other things going on also -- arthritis in my knees, neuropothy in my legs and feet and lymphedema. Because of all this I can't manage getting in and out of any car and am now home bound. I am so depressed also but keep on keeping on!

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@charlena

My husband is still on prednisone, it's been nearly 2 years. He has tried several times to decrease, but has always had to go back to initial doseage.
He is again trying a reduced doseage. Do you mind telling us what your symptoms are?
At his last doctor visit as the doctor was going over his symptoms, etc. he made the statement, "..... polymylagia rheumatica, if that is what you have, . .. ." Needless to say, we weren't happy with that statement. Another of his doctors advises that my husband's symptoms are not like any symptoms of patients he sees that have polymyalgia rheumatica. I research daily on my husband's symptoms and when I mention to his rheumatologist he doesn't seem interested in other possibilities. Probably time for a new doctor.

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@alanbruce, I think eating more is part of it but it's also because prednisone causes the body to retain sodium and lose potassium. I think being on prednisone actually makes you more hungry than you would normally be. More info/details on these two links:

https://www.livestrong.com/article/349434-why-do-people-gain-weight-on-prednisone/
https://www.drugs.com/slideshow/prednisone-faq-1088

I have tried to change my lifestyle from live to eat to eat to live...which is not too easy to do for me. So I focus on no fast foods, limiting snacks and eating more veggies to keep my weight gain to a minimum. I have been making "green" smoothies for my breakfast 3 or 4 days a week using some basic smoothie recipes I got out of the Wahls Protocol book. I mix up the greens but normally have a handful of spinach, kale, arugula or spring greens along with blueberries or whatever berry type fruit I have on hand. Frozen fruit is just as good as the fresh for the smoothies. I add a cup of water or coconut water that has no added sugar. 8 oz of coconut water gives you more potassium than the average banana (or so I have been told). I was surprised that a glass of the smoothie will hold me until lunch time.

What has helped me a lot is weighing myself every morning when I take a shower. When I was in Weight Watchers they always said that is a no no because you can get depressed but I found that if I know I'm up a pound I have an incentive that day to cut back a little more and be extra careful. I think my first round with PMR I probably gained 30 to 40 lbs. This time I've kept the weight gain under 10 lbs and going between 5 and 8 pounds up and down.

I'm sure it's different for everyone and you just have to find some system that works for you. Exercise is a big help though.

John

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@johnbishop

Hello @charlena, my symptoms are shoulder and arm pain/tingling. I'm a side sleeper and was waking in the middle of the night with my hands and arms feeling like they were asleep with numbness/tingling. The shoulder joints were painful but hard for me to describe how much pain. This started in August 2016 when my polymyalgia rheumatica came out of remission. The first diagnosis of PMR was in January 2007. I was put on 20 mg prednisone for both times. Also, I had hip pain along with the arm and shoulder pain/stiffness for the first bout of PMR.

I was able to taper down to 7 mg dosage by July 2007 but it took me until July 2010 to totally taper off of prednisone the first time. I had went back up to 10 mg by March 2009 and the rheumatologist had me taper 1 mg a week and if the pain came back I would go back up 1 mg for 3 days then drop again. From Jan 2010 to Jul 2010 I was going from 1 mg to 1/2 mg up and down until the symptoms went away July 17, 2010. It was hard for me to believe that 1/2 mg could make that much difference but it did. I also did not like splitting the 1 mg tablets. Now I'm having the same difficulty tapering off prednisone for this second PMR flare up.

@charelena did your husband see a rheumatologist or was is your primary care doctor? If not a rheumatologist, I think it would be a good idea to see a rheumatologist since they would have more experience with this condition.

Good luck - your husband is lucky to have you for an advocate. Keep asking questions of the doctors. The more you can learn, the better questions you can ask and hopefully the better care you can get for your husband.

John

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John I had the tingling in arms ,hands At night instead of laying on a pillow I just lay on bed ,when I removed the pillow tingling stopped.Try it see if it works for you

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@amkaloha

Hi Barbararene,
I have been meaning to write for a few days and finally have a few moments to myself! I was diagnosed with PMR on March 4, 2015 by my primary care doctor who is a D.O. and very much into natural healing as opposed to drugs. I remember when she said it, it looked like she had an epiphany! I guess she put it all together--my high inflammation markers and terrible pain across my shoulders and in my arms that wouldn't go away. I was already on Tramadol but that did not help this. She said the standard drug for PMR is prednisone but she did not want to put me on it because of my higher glucose level. Most often it was near 120 and I was not on any medication, just controlled it with diet, so she didn't want it to go higher or for me to have to take a drug.

There is a whole story as to how I came to the following, but I'll spare you the details and just tell you that we found that methylprednisolone did not raise glucose levels as much as regular prednisone. So, after she tried me on Methotrexate (the 'other' drug of choice) and I got so sick on just one dose of it, she put me on the methylprednisolone 4 mg. I have been on this dosage from the beginning and have tried a few times to go lower by taking 1/2 pill one day then the whole pill for a few days, etc. I could never get to a lower dosage without my pain coming back. In fact, at the 4 mg dosage I still have a little pain in my arms especially when I get up in the morning and sometimes in the late afternoon but I'm not into raising the dosage.

I was wondering if anyone on here could tell me how long it has taken for them to go into remission. I know everyone is different, but I guess I'd like to know if there is some light at the end of this tunnel??? And, Barbara, I'm with you, I drink some wine also but have been thinking of giving it up to see if that helps.

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I John yes thats what I take only 1000 mg magnesium,Vit D3 and calcium I understand we need more of these minerals also I don't sleep on a pillow ,this stopped the nerve pain in arms,hands try it ,see if this helps you.

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@johnbishop

Hello @charlena, my symptoms are shoulder and arm pain/tingling. I'm a side sleeper and was waking in the middle of the night with my hands and arms feeling like they were asleep with numbness/tingling. The shoulder joints were painful but hard for me to describe how much pain. This started in August 2016 when my polymyalgia rheumatica came out of remission. The first diagnosis of PMR was in January 2007. I was put on 20 mg prednisone for both times. Also, I had hip pain along with the arm and shoulder pain/stiffness for the first bout of PMR.

I was able to taper down to 7 mg dosage by July 2007 but it took me until July 2010 to totally taper off of prednisone the first time. I had went back up to 10 mg by March 2009 and the rheumatologist had me taper 1 mg a week and if the pain came back I would go back up 1 mg for 3 days then drop again. From Jan 2010 to Jul 2010 I was going from 1 mg to 1/2 mg up and down until the symptoms went away July 17, 2010. It was hard for me to believe that 1/2 mg could make that much difference but it did. I also did not like splitting the 1 mg tablets. Now I'm having the same difficulty tapering off prednisone for this second PMR flare up.

@charelena did your husband see a rheumatologist or was is your primary care doctor? If not a rheumatologist, I think it would be a good idea to see a rheumatologist since they would have more experience with this condition.

Good luck - your husband is lucky to have you for an advocate. Keep asking questions of the doctors. The more you can learn, the better questions you can ask and hopefully the better care you can get for your husband.

John

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question: i have both RA and PA yet for some reason i do not have stiffness when waking up. I do appreciate this but curieosity opens it's eyes. The stiffness seems to be expected. I do have much stiffness when the pain, swelling and cramping comes into being which seems to be happening much more often as time goes bye.

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@charlena

My husband is still on prednisone, it's been nearly 2 years. He has tried several times to decrease, but has always had to go back to initial doseage.
He is again trying a reduced doseage. Do you mind telling us what your symptoms are?
At his last doctor visit as the doctor was going over his symptoms, etc. he made the statement, "..... polymylagia rheumatica, if that is what you have, . .. ." Needless to say, we weren't happy with that statement. Another of his doctors advises that my husband's symptoms are not like any symptoms of patients he sees that have polymyalgia rheumatica. I research daily on my husband's symptoms and when I mention to his rheumatologist he doesn't seem interested in other possibilities. Probably time for a new doctor.

Jump to this post

Yes that is true it goes dormant for how long well that depends on our bodies. Everybody that has or have had PMR are different I think our metabolism are all different some people put on weight because of the prednisone & then there is the pain. Now listening to all who are on the Mayo support group all are different except of the joint pains. I consider myself very lucky I'll tell you why I am 76 I am 5'7' tall, I have had PMR since Feb or March of 2017. I started on 20 mg of Pred. now down to 7.5 mg/day. I have never put on weight which is strange, I also am an avid gym person maybe it has something to do with it. I do take 5000 mg of D3/day of course at my age I am on BP medication I am also a celiac intolerance person I have been for 16 years but doing well with it. Like I said at the beginning there are no 2 cases alike. As far as weaning off the Pred. take it slowly even if you do not feel any pain that doesn't mean that you can drop a mg or 2. Myself as I said I am on 7.5 mg/day. Now I will attempt to drop another mg or so at the beginning of Feb. if it works good but if it doesn't I will increase my body will tell me if I am ready to decrease my Pred. Also I have not had any reactions to the Pred. so I do have an advantage over most but I also have to be careful. Mostly exercise is very important & I mean real exercise my down hill skiing has not bothered me at all. Good luck to all who have to cope with this annoying auto. disease.

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@johnbishop

Hello @charlena, my symptoms are shoulder and arm pain/tingling. I'm a side sleeper and was waking in the middle of the night with my hands and arms feeling like they were asleep with numbness/tingling. The shoulder joints were painful but hard for me to describe how much pain. This started in August 2016 when my polymyalgia rheumatica came out of remission. The first diagnosis of PMR was in January 2007. I was put on 20 mg prednisone for both times. Also, I had hip pain along with the arm and shoulder pain/stiffness for the first bout of PMR.

I was able to taper down to 7 mg dosage by July 2007 but it took me until July 2010 to totally taper off of prednisone the first time. I had went back up to 10 mg by March 2009 and the rheumatologist had me taper 1 mg a week and if the pain came back I would go back up 1 mg for 3 days then drop again. From Jan 2010 to Jul 2010 I was going from 1 mg to 1/2 mg up and down until the symptoms went away July 17, 2010. It was hard for me to believe that 1/2 mg could make that much difference but it did. I also did not like splitting the 1 mg tablets. Now I'm having the same difficulty tapering off prednisone for this second PMR flare up.

@charelena did your husband see a rheumatologist or was is your primary care doctor? If not a rheumatologist, I think it would be a good idea to see a rheumatologist since they would have more experience with this condition.

Good luck - your husband is lucky to have you for an advocate. Keep asking questions of the doctors. The more you can learn, the better questions you can ask and hopefully the better care you can get for your husband.

John

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Well tingling in hands & arms are normal for older people why I don't know but my Dr. said it is common as long as it goes away when changing sleeping positions so no need to worry about it & it is not PMR related.

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@johnbishop

Hello @charlena, my symptoms are shoulder and arm pain/tingling. I'm a side sleeper and was waking in the middle of the night with my hands and arms feeling like they were asleep with numbness/tingling. The shoulder joints were painful but hard for me to describe how much pain. This started in August 2016 when my polymyalgia rheumatica came out of remission. The first diagnosis of PMR was in January 2007. I was put on 20 mg prednisone for both times. Also, I had hip pain along with the arm and shoulder pain/stiffness for the first bout of PMR.

I was able to taper down to 7 mg dosage by July 2007 but it took me until July 2010 to totally taper off of prednisone the first time. I had went back up to 10 mg by March 2009 and the rheumatologist had me taper 1 mg a week and if the pain came back I would go back up 1 mg for 3 days then drop again. From Jan 2010 to Jul 2010 I was going from 1 mg to 1/2 mg up and down until the symptoms went away July 17, 2010. It was hard for me to believe that 1/2 mg could make that much difference but it did. I also did not like splitting the 1 mg tablets. Now I'm having the same difficulty tapering off prednisone for this second PMR flare up.

@charelena did your husband see a rheumatologist or was is your primary care doctor? If not a rheumatologist, I think it would be a good idea to see a rheumatologist since they would have more experience with this condition.

Good luck - your husband is lucky to have you for an advocate. Keep asking questions of the doctors. The more you can learn, the better questions you can ask and hopefully the better care you can get for your husband.

John

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Thanks @lioness - I normally am a side sleeper and have to use a pillow, can't sleep on my back. I do try to make sure I keep my arm and hands not under the pillow ... which like you say gives you some pins and needles.

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@johnbishop

Hello @charlena, my symptoms are shoulder and arm pain/tingling. I'm a side sleeper and was waking in the middle of the night with my hands and arms feeling like they were asleep with numbness/tingling. The shoulder joints were painful but hard for me to describe how much pain. This started in August 2016 when my polymyalgia rheumatica came out of remission. The first diagnosis of PMR was in January 2007. I was put on 20 mg prednisone for both times. Also, I had hip pain along with the arm and shoulder pain/stiffness for the first bout of PMR.

I was able to taper down to 7 mg dosage by July 2007 but it took me until July 2010 to totally taper off of prednisone the first time. I had went back up to 10 mg by March 2009 and the rheumatologist had me taper 1 mg a week and if the pain came back I would go back up 1 mg for 3 days then drop again. From Jan 2010 to Jul 2010 I was going from 1 mg to 1/2 mg up and down until the symptoms went away July 17, 2010. It was hard for me to believe that 1/2 mg could make that much difference but it did. I also did not like splitting the 1 mg tablets. Now I'm having the same difficulty tapering off prednisone for this second PMR flare up.

@charelena did your husband see a rheumatologist or was is your primary care doctor? If not a rheumatologist, I think it would be a good idea to see a rheumatologist since they would have more experience with this condition.

Good luck - your husband is lucky to have you for an advocate. Keep asking questions of the doctors. The more you can learn, the better questions you can ask and hopefully the better care you can get for your husband.

John

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Hi Peach @peach414144, I've forgotten what it feels like to not have stiffness when I wake up. ☺ That's really the reason I try to ride my exercise bike for 30 minutes when I first get up in the morning...it loosens up the joints. Of course I have to feed the pets first or would have to listen to some aggravating noises until I stopped and fed them.

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@johnbishop

Hello @charlena, my symptoms are shoulder and arm pain/tingling. I'm a side sleeper and was waking in the middle of the night with my hands and arms feeling like they were asleep with numbness/tingling. The shoulder joints were painful but hard for me to describe how much pain. This started in August 2016 when my polymyalgia rheumatica came out of remission. The first diagnosis of PMR was in January 2007. I was put on 20 mg prednisone for both times. Also, I had hip pain along with the arm and shoulder pain/stiffness for the first bout of PMR.

I was able to taper down to 7 mg dosage by July 2007 but it took me until July 2010 to totally taper off of prednisone the first time. I had went back up to 10 mg by March 2009 and the rheumatologist had me taper 1 mg a week and if the pain came back I would go back up 1 mg for 3 days then drop again. From Jan 2010 to Jul 2010 I was going from 1 mg to 1/2 mg up and down until the symptoms went away July 17, 2010. It was hard for me to believe that 1/2 mg could make that much difference but it did. I also did not like splitting the 1 mg tablets. Now I'm having the same difficulty tapering off prednisone for this second PMR flare up.

@charelena did your husband see a rheumatologist or was is your primary care doctor? If not a rheumatologist, I think it would be a good idea to see a rheumatologist since they would have more experience with this condition.

Good luck - your husband is lucky to have you for an advocate. Keep asking questions of the doctors. The more you can learn, the better questions you can ask and hopefully the better care you can get for your husband.

John

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yes, i think the animals keep us going. on. the responsibility for them gives us another reason to enjoy life for them and for us. (2 cats and 2 dog)

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