Hi Pam @pb50, Only my initial onset of PMR when I was first diagnosed did I feel the type of pain you are describing. The flare ups I had when tapering off before the PMR went into remission didn't feel as bad as what you are experiencing. My rheumy was always telling me to watch for facial and head/jaw pains because he was concerned about GCA and vision being affected. 20 mg prednisone was the largest dose that I took for both of my PMR occurrences.

It might be worth a discussion with your doctor on trying a lower dose for a few days to see if it gets rid of your pain vs starting at 30 mg. Mike @dadcue has a lot more experience that I do so may have some better suggestions. Do you have any swelling in the hands or feet that goes along with the pain?

@pb50 Hi Pam

For uveitis, I used to start at 60 mg per the instructions from my ophthalmologist. I was given permission to increase my dose as needed upwards to 100 mg if the uveitis didn't respond. I would quickly taper back down after the uveitis "responded" which was when there was an improvement in the inflammation inside my eye.

Uveitis offers a unique visualization of inflammation so my ophthalmologist and I could tell how the inflammation responded. This "real-time" observation of inflammation is valuable because both my ophthalmologist and I knew when there was a reduction or elimination of inflammatory cells. Knowing precisely how much inflammation was present confirmed the dose of prednisone that I needed and how quickly I could taper off prednisone.

For uveitis, I could usually taper off within a month and uveitis would stay in remission for a year or so. I lost count at over 30 flares of uveitis in 20 years. I got a lot of practice taking prednisone and tapering off again.
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After PMR was diagnosed, I started out with 30-40 mg but I could not reduce my dose very much for about 10 years. I had many reasons for taking prednisone and my doctors understood why I needed so much prednisone. My doctors never questioned my judgement. I didn't have too many qualms about taking 100 mg when needed. I could handle 60 mg of Prednisone reasonably well but that was my "self imposed limit" without guidance from my doctors. I would tell my doctors if I ever needed more than 60 mg. My "absolute limit" was 100 mg. If my doctors ever wanted me to take more than 100 mg -- I refused because I can't tolerate that much.
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I'm concerned that you now need significantly more prednisone than you did. Doubling your usual dose suggests something that isn't good is happening. However, I'm not overly concerned about 30 mg as long as you can still reduce that dose back down to your usual dose and eventually taper off again. Getting "stuck on prednisone" isn't a good situation.

@pb50
I have a lengthy response but think it is relevant to how PMR may start for some people. I had knee pain in 2018 and I 2025.
Knee pain is exactly how my PMR starts. I had to use crutches as I couldn’t put pressure on my right knee or bend it. I took 3 Aleve and elevated the knee and would get relieve. I had hip replacement surgery within 3 months of this knee pain happening. So my 2018 episode was hidden by my surgeries.
Same knee pain came st the beginning of 2025.
Very soon after I started getting sore hips then shoulders then whole body pain that kept me from getting out of bed pain. I went to a knee specialist oth times and they said my knee was fine. And it is. My knee is pain free except for this. I wonder if anyone has had a similar one joint flare up before heading to the rest of the joints?

@pb50
Dr Kate Gilbert’s book on PMR/GCA is fantastic. Buy and read it. Too much info to get into here re: prednisone but she covers it extensively. Extremely helpful. A PMR survivor, she is clear and free now.
Best.