Prednisone tapering

Posted by betsyhase @betsyhase, 15 hours ago

I started Prednisone on 2/6/26 after being diagnosed with PMR. My starting dose was 12.5mg which gave me great relief but not totally. My PCP wants me to decrease by 1 mg per month. My concern is that I am noticing the joints in my hands are still swollen and stiff. This is an improvement from where I started but not my normal. My knees are in pain and weakness in my legs is constant. I am also retaining fluid by noticing my weight going up and feeling puffy. I am to get some bloodwork done on 4/9.
My question is did you get completely pain free with Prednisone?

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

@betsyhase, It seems like you are fairly early in your diagnosis and treatment of PMR. For both of my occurrences of PMR I my starting dose was 20 mg prednisone and usually within an hour or so of taking my dose, I was relatively pain free (less than 1 on my personal pain scale of 0 to 10) and quite a bit of the time was at 0 pain. Everyone is different and tapering can be a challenge. Some doctors do want to get you off of prednisone as soon as possible but I don't think there is a set rule for everyone. My rheumatologist had me keep a daily journal of my level of pain when I woke up in the morning and the dosage for that day. The main reason was if my pain level when I woke up was more than what I considered acceptable (less than 2) then he told me I should delay my taper for a few days when it was time to taper or possibly increase the dosage half of my previous taper down so that I was still making progress with my tapering schedule.

You might find this discussion by @dadcue helpful.
-- How to Slowly and Safely Taper Off Prednisone but ... no set rules.
https://connect.mayoclinic.org/discussion/how-to-slowly-and-safely-taper-off-prednisone-but-no-set-rules/
It sounds like the treatment is not controlling your pain very well. There may be other treatments that might also help. Have you discussed it with your doctor or rheumatologist?

REPLY
Profile picture for John, Volunteer Mentor @johnbishop

@betsyhase, It seems like you are fairly early in your diagnosis and treatment of PMR. For both of my occurrences of PMR I my starting dose was 20 mg prednisone and usually within an hour or so of taking my dose, I was relatively pain free (less than 1 on my personal pain scale of 0 to 10) and quite a bit of the time was at 0 pain. Everyone is different and tapering can be a challenge. Some doctors do want to get you off of prednisone as soon as possible but I don't think there is a set rule for everyone. My rheumatologist had me keep a daily journal of my level of pain when I woke up in the morning and the dosage for that day. The main reason was if my pain level when I woke up was more than what I considered acceptable (less than 2) then he told me I should delay my taper for a few days when it was time to taper or possibly increase the dosage half of my previous taper down so that I was still making progress with my tapering schedule.

You might find this discussion by @dadcue helpful.
-- How to Slowly and Safely Taper Off Prednisone but ... no set rules.
https://connect.mayoclinic.org/discussion/how-to-slowly-and-safely-taper-off-prednisone-but-no-set-rules/
It sounds like the treatment is not controlling your pain very well. There may be other treatments that might also help. Have you discussed it with your doctor or rheumatologist?

Jump to this post

@johnbishop
Thanks for your detailed reply. I guess in the beginning I was so glad for any relief and at the same time, fearful of taking Prednisone. I guess I will have to wait until after my next blood test before I can get my PCP to listen. At this time I am on a wait list for a Rhumatologist. There are very few in our area.

REPLY
Profile picture for betsyhase @betsyhase

@johnbishop
Thanks for your detailed reply. I guess in the beginning I was so glad for any relief and at the same time, fearful of taking Prednisone. I guess I will have to wait until after my next blood test before I can get my PCP to listen. At this time I am on a wait list for a Rhumatologist. There are very few in our area.

Jump to this post

@betsyhase if you have enough prednisone, you may want to delay your taper.

REPLY

I have had PMR for about a year. I started
Prednisone at 10 m which in two days took all the pain away. After nine months I began the journey to lower my dose. Over several weeks I was down to 5m. I stayed on this for several months and in late February began lowering again. I was fine on 4m but after two days on 3m I woke up in original pain and as soon as I took 4m the next day I was pain free. My doctor last week said after a few weeks I can start 3 m one day and 4m the next and alternate like this to see how that works. I have found that is a trial and error process.

REPLY
Profile picture for nrrchachi @nrrchachi

I have had PMR for about a year. I started
Prednisone at 10 m which in two days took all the pain away. After nine months I began the journey to lower my dose. Over several weeks I was down to 5m. I stayed on this for several months and in late February began lowering again. I was fine on 4m but after two days on 3m I woke up in original pain and as soon as I took 4m the next day I was pain free. My doctor last week said after a few weeks I can start 3 m one day and 4m the next and alternate like this to see how that works. I have found that is a trial and error process.

Jump to this post

@nrrchachi
My PCP is stuck on decreasing 1mg per month. A site he researched gave that coarse of treatment. I am sure I need to increase dose but since I have bloodwork ordered for this Thursday, I will wait to see what the results are before messing with the dosage.
Thanks for your feedback.

REPLY
Profile picture for nrrchachi @nrrchachi

I have had PMR for about a year. I started
Prednisone at 10 m which in two days took all the pain away. After nine months I began the journey to lower my dose. Over several weeks I was down to 5m. I stayed on this for several months and in late February began lowering again. I was fine on 4m but after two days on 3m I woke up in original pain and as soon as I took 4m the next day I was pain free. My doctor last week said after a few weeks I can start 3 m one day and 4m the next and alternate like this to see how that works. I have found that is a trial and error process.

Jump to this post

@nrrchachi the alternating worked well for me…..it

REPLY
Please sign in or register to post a reply.