The lowest effective dose, how is it defined?

I had the same stiffness and minor aches in the morning before I took my daily dose of prednisone but the pain and stiffness generally stayed away until the next day for me but others here on Connect have mentioned it returning at night. I think some have tried splitting their doses but I never had to do that for relief at night.

@dadcue and others have mentioned alternatives to prednisone that enable them to get off of prednisone and may have some suggestions.

I will ask my doctor this week about splitting doses. He told me recently that it generally is not a good idea to take prednisone at night since it could have sleep side effects. The best time is the morning with breakfast.

It was so long ago that I forget. If I forget to take my regular dose I notice some pain. I'm dealing with pain from spinal stenosis as well. So it is difficult to decide if its the prednisone or the Tramadol or lately my combination of acupuncture and lazar treatment that's helping.

Just listen to your doctor. Believe it or not it was a back doctor who discovered my PMR. I was complaining about the pain in my arms when I was trying to do the excercises to help my back.

Splitting the dose does not mean splitting it 50/50. If the dose is split to control morning pain, the advice is to take a smaller dose in the late afternoon or early evening so as not to affect sleep. A later dose of even 1-2mg of the daily dose can be enough to control morning pain without affecting sleep.

A week after starting on 15mg of prednisolone my pain was improved by 70%. To me that was disappointing. It took a few weeks and splitting the dose to take 2mg of it later in the day to have 95% improvement. Some people have immediate relief and others of us have to be a bit more patient.

Sorry to hear that your pain has returned. Were you able to return to regular activities before the pain came back?

@mycare18

👍

I'm on my second round of Prednisone and this time instead of coming down 1mg every month I alternate 3mg then 2mg every other day for two weeks then 2mg for four weeks. Next round will be 2 and 1 alternating every other day for two weeks the down to 1. Has been working great so far.

@urusvati and @jeff97 , I've been doing both of your suggested exercises each day for over a month now and haven't had any awful shooting pain down my leg for several weeks. None at all, even after bending down to weed in the garden which had always made it much worse. I read recently that 80-90% of sciatic pain can be resolved with targeted exercises, and that proved to be the case with me. So thank you both so much for making life a bit easier.

@megz
I'm glad you're feeling so much better. That's great.

I've had an interesting experience lately that shows how much benefit you can get from targeted exercises and proper footwear. I was having significant pain on the inside of my left knee. It happened mainly when I was walking or running, and it would stiffen up when I was sitting for an extended period of time. I went to an orthopedic doctor to get it examined. He just looked at the xray of the knee and said that it was arthritis. He said I could take NSAIDs if I wanted, but that was pretty much all I could do. I wasn't sure if he was correct. I thought maybe my foot was turning out a little or else my arch was flattening out too much when I walked or ran. I started using some orthotics I got several years ago but never used. I thought the orthotics would provide better arch support than the insoles I was using. I also started doing several exercises I found on YouTube, mainly to build the quad and glute muscles. I did them every day for a week, and then switched to every other day. Within 2 or 3 weeks the pain was completely gone. I've had other experiences with orthopedic doctors where they only seem interested in surgery.