Pushing through "increasing pain" while continuing a taper probably isn't a good idea.

I believe what happens more often is that people immediately increase their prednisone dose for any uptick in pain. Each new pain should be investigated because it might not be PMR. However, doing another investigation isn't always practical after PMR is diagnosed.

Much of my pain through the years wasn't anything like my original PMR symptoms. I would complain to my rheumatoloist that I thought PMR slipped out the back door and the treatment left me in a world of hurt. She seemed to understand but it still meant I needed to take prednisone.

I understand wanting to be "pain free" but perhaps that won't facilitate tapering off prednisone. It is more about accepting "tolerable pain" vs "no pain." The "fear of pain" sometimes controlled me more than the pain. Does that makes sense?

I'm not the best person to tell anyone how to taper off prednisone since I took it for 12 years for PMR. I'm in awe of people who are able to taper off prednisone sooner than I did. However, the experience with Prednisone I had before PMR was diagnosed was that I could routinely taper off prednisone going from 60 mg to zero in a month or two. My ophthalmologist who was treating uveitis said I was "skilled" at doing Prednisone tapers. I had a lot of practice treating flares of uveitis which can also cause vision loss. The only difference was "short term" vs "long term" prednisone use.

In spite of 12 years on prednisone ... I was able to taper off. In some ways it was harder for me to taper off prednisone after such a long time. The biologic I now take made it much easier for sure. The other thing that helped me was when I was told that I should NOT taper at all when I was at 3 mg. It was hard to resist the temptation to increase my prednisone dose but the endocrinologist said to only increase my dose when it was "absolutely necessary."

The difficulty was knowing if it was necessary or not because it wasn't like having "no pain." I had to stay on 3 mg for six months until my cortisol level improved. Six months wasn't a "predetermined" length of time. My endocrinologist actually said "as long as it takes" for my cortisol level to improve.