The lowest effective dose, how is it defined?

There isn't a single answer to that. The standard answer is that you return to the last effective dose and stay there till pain resolves and things stabilise. But it depends on the individual and their doctor. Some people take a few mg more for a few days before dropping to the last effective dose and staying there for a bit before resuming the reductions.

I've had only one flare last year at 6.5mg/6mg, so my flare management experience is limited. At the time, I waited on 6mg to see if the new pain would resolve but it got slowly worse over a month or so. reaching 5-6/10 before I knew it was a flare. Doctor said to go to 15mg for 5 days to resolve the pain, then drop back to a dose just above the flare dose. In my case, the pain was not improved at all after 5 days on 15mg, so I only reduced by a couple of mg. There is a window of fast reductions of 2 weeks (3wks tops) after a big rise in dose, after which only slow reductions can be made again. It took a month for my pain to go away, so the opportunity for a fast reduction was gone and I had to proceed with the original slow taper from 12.5mg.

So it can depend if you are a quick responder to prednisone (I am not), or if you have to be more patient. There's no set rule - everyone is different. It would be good if others could give you their experiences too.

I’ve reduced the prednisone to 3 mg …going down one mg a month …the first week of reduction is not too bad but the second one is very difficult …usually by the third week it’s starting to recover…and then I have ten days of thinking I’m doing well…. But then it’s time to reduce again …I’m in the middle of the second week atm and hoping it follows the same pattern this time…I take Actemra once a week …fingers crossed it does its job!

I'm in the same boat as you Megz. I had a little pain after I reduced to 8mg. At 7mg there was a bit more. I kept reducing anyhow. I am now at 6.5 and there is a little more. I'm going to try 7mg, 6.5mg, 7mg, 6.5mg, alternating daily.

At this point, I don't want to go above 7. I'd rather live with the pain. Hoping it doesn't worsen.

Do you know if your inflammation levels have increased along with the pain? What level of pain on a 1-10 scale would you say you're having? I left the inflammation too long and it settled in, so that things like turning a door knob and doing normal things were difficult again. I'm as keen as anyone else not to increase the dose, but consistent inflammation control is key to successfully beating PMR. What are your inflammation levels like?

My levels have been down (even with a little pain--say a 3 level in am) but I haven't had a test since under 9. Right now I am out of town. I have an appointment in ten days when I go home, and they'll test my levels. I'll let you know. My pain is about a 5 or 6 in the am and a 2 or 3 in the evening. It settles down quite a bit during the day. I still run and lift. I worry about ignoring the pain/inflammation for too long, also.

This is a nightmare.

I take 5 mg every other day. There is no suggestion that I go off it.

@mycare18

I was diagnosed with PMR 11 days ago and was prescribed with 15 MG's per day for 30 days. How long did it take to be pain free after the initial diagnosis?

Welcome @mycare18, I've had 2 occurrences of PMR and started treatment at 20 mg prednisone. I had pain relief within a few hours of taking each dose and the pain generally stayed away until the following morning. It took me 3 and half years to taper off of prednisone the first time and 1 and half years the second time.

@dadcue share a really good video in another discussion that you might find helpful.
-- Video: Steroids and PMR - International Panel of Doctors
https://connect.mayoclinic.org/discussion/video-steroids-and-pmr-international-panel-of-doctors/
There are other conditions with symptoms that mimic PMR. Do you get any pain relief from the prednisone? Do you keep a daily journal or log of your level of pain each day?

I have not kept a daily log. It is a good idea. Over the 11 days, I have had 2 complete days of no pain or stiffness. My daily pattern is stiffness, pain in the shoulder and right arm early am with some difficulty getting up from a chair. By the late am in the past few days I feel ok. I do some physio and walks during the day. By the late evening I get some mild pain before bedtime. Difficulty sleeping on both sides and have learned to sleep on my back. Appreciate all the feedback.

mycare18
How long did it take you after your first round of PMR to get back to your regular activities?