PMR and Flu Vaccine

I have recently been diagnosed with PMR and they have started me on 20mg of Prednisone daily. I know it's early yet "day 13" but i have had no relief for the pain yet. I to am concerned about mobility issues as my knees are very sore and stiff in the mornings and throughout the day. I usually take a couple of Tylenol which provides some relief. (Tylenol has been approved by my liver specialist and Prednisone by my Rheumatologist) I have the pain in my upper back, lower neck, arms , on the pain scale out of 10 I would give most days a 5 to 6, but the worse is in the "Right" shoulder, left shoulder is mild pain. This pain wakes me up at night, it's a sharp pain, out of 10 i give it an 8 and it can last a few hours . I now take a couple of Tylenol later at night before going to sleep (1:00am) This gets me through the night until about 7-8 am the next morning, I'm unable to make any plans as I have no idea how I will feel after being awake for an hour or so. Life is very frustrating right now and I'm not understanding why. I have spoken with my my Rheumatologist concerning and they have told me to be patient and stay the course, sometimes Prednisone takes awhile to kick in I'm being told . That was a week ago and i don't see her again until October 17th along with my monthly blood work that i will provide. Is there anyone out there having the same problem with the Prednisone not working, extreme pain in the right shoulder. I have also began reading and investigating a condition called Referred Pain as i have also been recently diagnosed with liver cancer. At this time it seems to be one of the lower level cancers but i will be seeing a specialist in the coming weeks and hopefully be cured. I'm also reading about another condition called Steroid resistant. Bad thing with all this is that there are two many rabbit holes, don't over read and let the doctors do there jobs.

I have recently been diagnosed with PMR and they have started me on 20mg of Prednisone daily. I know it's early yet "day 13" but i have had no relief for the pain yet. I to am concerned about mobility issues as my knees are very sore and stiff in the mornings and throughout the day. I usually take a couple of Tylenol which provides some relief. (Tylenol has been approved by my liver specialist and Prednisone by my Rheumatologist) I have the pain in my upper back, lower neck, arms , on the pain scale out of 10 I would give most days a 5 to 6, but the worse is in the "Right" shoulder, left shoulder is mild pain. This pain wakes me up at night, it's a sharp pain, out of 10 i give it an 8 and it can last a few hours . I now take a couple of Tylenol later at night before going to sleep (1:00am) This gets me through the night until about 7-8 am the next morning, I'm unable to make any plans as I have no idea how I will feel after being awake for an hour or so. Life is very frustrating right now and I'm not understanding why. I have spoken with my my Rheumatologist concerning and they have told me to be patient and stay the course, sometimes Prednisone takes awhile to kick in I'm being told . That was a week ago and i don't see her again until October 17th along with my monthly blood work that i will provide. Is there anyone out there having the same problem with the Prednisone not working, extreme pain in the right shoulder. I have also began reading and investigating a condition called Referred Pain as i have also been recently diagnosed with liver cancer. At this time it seems to be one of the lower level cancers but i will be seeing a specialist in the coming weeks and hopefully be cured. I'm also reading about another condition called Steroid resistant. Bad thing with all this is that there are two many rabbit holes, don't over read and let the doctors do there jobs.

I can't comment on the first question because I am not over PMR yet. To the second question, no I do not get a flu shot. I got the shots yearly when I worked in health care because it seemed like the right thing to do to protect patients. About half the time I would have a reaction to the shot and feel ill for a couple of days. I always got the shot on a Friday so I would not have to work when I wasn't feeling well. In spite of the shots I twice got the flu, was sick for at least a week with temps up to 102. Then in 2020, the Covid year, I got my flu shot and had a worse than normal reaction, spiked a fever for 5 days straight. My Covid test was negative. In early 2021 I got the Covid vaccine and PMR shortly after. I told my rheumatologist that I am not getting any vaccines for the time being and he did not give me any flak about it when I explained my reasons. I think in general vaccines are good but they aren't always appropriate for everyone. I haven't had any colds or flu since 2021. I don't fly on planes. I do shop, eat in restaurants and attend meetings as much as I want.

Hello @paul767, I would like to add my welcome along with @jeff97 and others. You might want to take a look at the discussion started by another member @cliffg26 - I’m Not Responding to Prednisone and I Need Advice: https://connect.mayoclinic.org/discussion/im-not-responding-to-prednisone-and-i-need-advice/.

Have you tried splitting your dose? There are a lot of threads in this forum about that. You could try taking 15 mg in the morning and 5 in the late afternoon, or some other combination. Taking the second dose later in the day might help you get through the night without pain. If that doesn't work your dose might be too low. My brother-in-law started at 30 mg.

I have always been vaccinated with a flu shot until last year. I was diagnosed with GCA and PMR in November 2023. I have mild PMR that occurs occasionally and on bad days I may take an Aleve. No more prednisone. Overall I have had some healing since 2023. I am reluctant to get the flu vaccine. As I have read studies that indicate it is sometimes the adjuvants in the vaccine that will cause our auto immune system to flare. My rheumatologist, who I no longer see is OK with the flu vaccine. I have also been seen by allergist/pulmonary physicians for 40 years. I am 72 years old. The allergist suggested that I get a “regular” flu shot and perhaps split the dose with two injections spread apart, he did not recommend that I get the “quad senior” flu shot. I am sitting on a fence post, still trying to make a decision as to what to do. I would like to prevent any possibility of a PMR flare.

The year before I got PMR/GCA, I took the 'senior' flu shot. I got very sick and felt pretty bad. Since then, I tell the pharmacist that I don't want the 'old people's' flu shot. I take it in one dose and haven't had any issues. I am on monthly Actemra infusions, which probably helps prevent any potential flare.

my PCP said no vaccines while on prednisone.