@54pontiac you can not just stop prednisone abruptly unless it’s under 2 weeks that you’ve been on it. You have to taper slowly.

@54pontiac I self treated two PMR flares within the first year after stopping the prednisone. I was familiar with the symptoms and I had left over prednisone. I did two days of 20mg two days of 10mg and 2 days of 5mg and stopped. Symptoms were gone. No withdrawals. I could not talk my Dr into prescribing me a backup 6 day dose. Of course they wanted to do all kinds of testing first.

@54pontiac

This is a 2-part question. I don't have any good answers for either part.

Part 1 of the question:

Why can't we do a blast of high dose of prednisone for a few days and then stop?
------------------------
This was how my other autoimmune disorders were treated before PMR was diagnosed. I frequently took 60-100 mg of Prednisone and tapered off within 30 days. The time varied depending on symptoms and starting dose but 30 days was the approximate time I needed to taper off. After I tapered off prednisone, remission of my other autoimmune conditions was sustained and I stayed off prednisone for about a year before relapsing again.

Why can't we do the blast of Prednisone and fast taper for PMR? It didn't work for me ... I tried. When I told my rheumatologist about doing a blast of prednisone and a fast taper she said, "PMR was going to be a long term proposition and I couldn't take prednisone that way for PMR." Her suggestion was to find a "stable dose of Prednisone that worked" and stay on that dose for awhile before tapering. She said I would probably need Prednisone for a couple of years for PMR.

A couple of years turned out to be 12+ years of prednisone for PMR. I never signed up for 12 years of PMR. Plus.... my stable starting dose of Prednisone was 35 mg which wasn't all that stable. PMR pain was controlled but my rheumatologist was in disbelief that my inflammation markers were still elevated on 35 mg of Prednisone!
---------------------
Part 2 of the question.

Why can't we stop before our adrenals have shut down and the side effects have set in?

I don't know. To be honest, I didn't know about my adrenals being shut down by Prednisone initially. I didn't learn about my adrenal problem until about 10 years later. I knew I needed to taper off Prednisone slowly because PMR would relapse if I tapered off Prednisone too quickly. I must have "relapsed" more than 100 times but my symptoms varied and were never exactly like my original PMR symptoms.

My initial symptoms involved pain and stiffness but originally PMR was mostly confined to shoulders until my entire body was in pain. I blamed the total body pain on not being diagnosed with PMR quickly. There was a delay in starting Prednisone. I told a PCP I took prednisone whenever I had pain caused by my other autoimmune conditions. My first PCP said I shouldn't take Prednisone without seeing a rheumatologist first. It took a couple of months for me to get an appointment with a rheumatologist.

@54pontiac because sadly pred doesn't cure PMR, it simply relieves the symptoms. Stop the pred, and the inflammation will begin to build again, slowly or rapidly depending on how aggressive your PMR is. PMR eventually goes away by itself, they say, but lasts much longer in some than others. They don 't know why.