How to address PMR pain while decreasing prednisone

Once you get to 10 mgs, reducing by 1/2 mg is recommended. Never reduce more than 10%. You want to reduce to the amount that takes care of the PMR inflammation but no lower, otherwise the inflammation keeps growing until you have a flare. If the PMR is gradually going into remission, you then have to make sure the adrenals are working before going any lower. The adrenals create cortisol, the equivalent of 6 or 7 mgs prednisone. Your body stops making cortisol when you are on pred for a long time. It takes a year or longer for adrenals to begin making cortisol again. Some adrenals do not recover and prednisone takes over. The slower you reduce, the greater chance for the adrenals to awaken.

I was on 6/7 mgs pred for almost two years. I am in my fifth year of PMR and am on 3 1.2 mgs. I would be lower except for an arthritic hip for which I am awaiting hip replacement. I use the following method (Dorset Lady's) to reduce: Sun-new dose other days old dose; Sun/Th new dose, other days old;SunTuTh new dose, other days old; SunTUWTHU new dose, others old; SunTUWThSat new, MF old; the following week all new dose. It is easy to stop if the new dose shows signs of a flare and prevents seesawing up and down..
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I have a question and a concern. I have PMR and have reduced (1 mg a month) now at 1.5. I certainly don't feel pain and discomfort like I did when I started on prednisone, but the last 2 weeks or so I have experienced slight discomfort in my neck, hips and thighs. It is certainly manageble and doesn't keep me from going about my daily exercise or sleeping. However, I read about others going up and down on prednisone to manage the pain and reduce the inflammation. Should I expect the discomfort to go away completely before quitting prednisone or do you taper to a level that is tolerable? My worry is that inflammation is still "brewing" and I may get GCA.

I have a question and a concern. I have PMR and have reduced (1 mg a month) now at 1.5. I certainly don't feel pain and discomfort like I did when I started on prednisone, but the last 2 weeks or so I have experienced slight discomfort in my neck, hips and thighs. It is certainly manageble and doesn't keep me from going about my daily exercise or sleeping. However, I read about others going up and down on prednisone to manage the pain and reduce the inflammation. Should I expect the discomfort to go away completely before quitting prednisone or do you taper to a level that is tolerable? My worry is that inflammation is still "brewing" and I may get GCA.

Thank you. This is helpful. Unfortunately, I was back up to 20 (from 5) because of big flare up and had to lower 1 mg every 4 days over 1 1/2 months to prepare to get the Pfizer Covid vaccine. I just received my second shot and will have to wait two weeks to start over with higher dose and SLOW! taper. Have lots of pain (have read the shot may induce it) right now. Tramadol and Tylenol help some. Looking forward to April.

@irishdancer, I think you ask a very good question that each of us has struggled with when tapering off of prednisone. I put my tolerable pain level between 1 and 2 on a scale of 1 to 10 with 10 being I can't take any more. But I'm sure the pain scale is different for each of us. When my primary care doc was following up with me, he was always asking about pain around my forehead and temples, jaw pain, scalp tenderness and then mentioned he wanted to make sure I didn't also have GCA. My discomfort never really went totally away when I tapered off the first time but if I remember correctly it was around a 1 or a tad more. I went back and forth between 1/2 mg and 1 mg prednisone the last six months of my first occurrence with PMR before I could finally taper off with tolerable pain/discomfort.

Do you keep a daily pain and dosage log? I think it would be a great question for your rheumatologist or doctor also.

I asked my Rheumatologist and pharmacist about having a glass of wine and being on prednisone. They both said it was okay. Sure hoping so!

I asked my Rheumatologist and pharmacist about having a glass of wine and being on prednisone. They both said it was okay. Sure hoping so!