@phoenix0509, I did start both occurrences of PMR with 20 mg prednisone. My rheumatologist suggested I keep a daily pain log and record the dosage as I was tapering down. He wanted me to taper off slowly and suggested I try going down by 2.5 mg every three days but that I could adjust up or down to find something that works for me. I was at around 10 mg prednisone at the 7 month mark my first time around with PMR. During that time I did go up and down a few times when the pain was too much. For me, i tried to only go back to the previous dose that was working and not higher. I never had to use methotrexate. One thing that is helpful when you are tapering is to have your doctor give you scripts for 1 mg, 2.5 mg and 5 mg prednisone tablets. That way you can easily go down or up in smaller increments.

Have you had a chance to discuss the pain flare with your rheumatologist to see if they have any suggestions?