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The lowest effective dose, how is it defined?
Polymyalgia Rheumatica (PMR) | Last Active: 6 days ago | Replies (141)Comment receiving replies
The tapering is all very confusing.
I had no pain at all until I lowered to 8. Then a little pain. At 7, more, so I went up to 7.5. Then down again to 7. I'm at 6.5 now and have had some great days and bad days. I could live with this amount of pain for the rest of my life but I want to get off the dang prednisone and so I'm trying to taper.
My question has always been, am I hurting myself if I continue tapering while I have pain? Eventually, I may taper to a point where I can't stand the pain. Until then, am I hurting myself?
Frustrating.
Thank you to the suggestion of different dosages on different days. I may try 6.5, 6.5, 6 ect. Will talk to doctor of course, but thanks!
Replies to "The tapering is all very confusing. I had no pain at all until I lowered to..."
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The answer is that you could be, but it is very confusing, as you said. If the pain that you are experiencing is due to steroid withdrawal, then it should alleviate after several days at the new lower dose. But how long that is going to take will vary from individual to individual.
But if the pain is from PMR inflammation, then staying at a lower dose is unlikely to be effective over the longer term. The pain rather then alleviating over time will possibly increase as the level of inflammation builds up. This is simply because you are not taking enough prednisone to control the level of prednisone produced by your body on a daily basis. Pain nearly always results in reduced movement and that will contribute to muscles weakening over time. If there is GCA/LVV with the PMR, then not getting the correct dose to control the illness completely becomes more critical because of eyesight or aorta damage.
It is all further complicated by the fact that the IL-6 inflammatory is thought to play a major role in the pain from steroid withdrawal and that is one of the primary inflammatories in PMR.