@ambershe -Hi...I too have been reducing my meds from 20mg, my Doctor recommended reducing it monthly and it worked to a certain extent. I also listened to my body and symptoms and if still there did not drop till things settled. I find when I reduce the dose I normally have more pain in my shoulders and neck and that is what I have judged it by when reducing. I was on 5mg for over 4 weeks as I just did not feel well enough to drop the dosage, around 6 weeks I reduced to 4mg and my symptoms came back and have slowly settled over a period of weeks, still there but as you say not the same as without meds and for me bearable. I will stick to the 4mg until my body adjusts. I find that each drop the symptoms return but over the weeks they slowly reduce and get to a point where I can drop another mg. I too have had severe pain in my knees that I did not have originally, not there all the time but bouts of this where they just ache and I can not kneel on them. Regarding your question if PMR is caused by stress, I feel that mine was. I had a terrible year where my mother passed and then my sister also within 3 months of my mother. At that time also my son was hospitalized with a mental condition and I feel that all this just caught up with me and became too much. I also notice that if I get stressed then my symptoms feel worse. Maybe something for you to note if your systems flare up if you have had stress prior to it. I keep a journal each day of how I feel and put down what things I eat and how I am feeling. This is good to look back on if you want to see a pattern. I hope this helps and good luck with reducing your meds.