Prednisone tapering: How did you do it pain free?

I've been on prednisone since February 25. My rheumatologist started me on 15mg prednisone after getting the first results from my blood work. Three weeks later I was diagnosed with PMR and because 15mg was only taking the edge off the pain, I was bumped up to 25mg. For two days I felt great but then the ache in my shoulders returned but at a much lower level and I had pain in my left hip and right knee. After about two weeks I started feeling full relief again but I still woke up with shoulder and hip pain until my prednisone kicked in. My shoulders would ache by the end of the day after doing light chores around the house. It's still difficult to do even the simplest things in the evening because of my shoulders feeling achy and weak. Last week I started getting horrible acid reflux after everything I ate and was taking Tums all day. My rheumatologist was on vacation so I started splitting my prednisone to 20mg in the morning and 5mg in the evening. That worked. Yesterday, my rheumatologist cut me down to 20mg. So far I don't feel any difference. Maybe splitting my dose helped. I'm going to do the same thing later this week by doing 15mg in the morning and 5mg in the evening. I see my rheumatologist again next week. I don't feel like I've ever been totally pain free for more than a couple of days on prednisone. My shoulders always have an ache to them, but I'm starting to feel more side effects of prednisone so I'm willing to put up with a little pain and discomfort, although I feel severely limited in what I'm able to do because of my shoulders.

@kjoed53 ….start a pain/meds/ activity journal.
Prednisone taper …my Dr says pain free before tapering.
If I understand, you have only been diagnosed for 6 weeks….from this blog and my own knowledge, I don’t know anyone who is/was on such a fast taper.
You are your own advocate. Splitting helped me. Also supplemented with Tylenol for arthritis.
Pain free is my motto…

@tweetypie13
I started a pain journal that includes activity and diet when I started prednisone. I'm having side issues that are increasing with time... elevated BP and HR, brain fog, PVCs and PACs, acid reflux, balance issues and shortness of breath. My sleep is horrible. How much of that is prednisone side effects, I don't know. I know that I don't feel any difference in pain between 25mg and 20mg. I'm seeing my primary care today and I'm also scheduled to see a hematologist because I probably have something else going on besides PMR based on my blood work. Tylenol did nothing for my pain and neither did ibuprofen. I have been my own advocate since October and I will continue to do so. I know I'm walking a fine line right now trying to balance everything, but six weeks ago I couldn't walk without a cane or do anything without extreme pain. This is nothing compared to where I was at the beginning.

@tweetypie13
I started a pain journal that includes activity and diet when I started prednisone. I'm having side issues that are increasing with time... elevated BP and HR, brain fog, PVCs and PACs, acid reflux, balance issues and shortness of breath. My sleep is horrible. How much of that is prednisone side effects, I don't know. I know that I don't feel any difference in pain between 25mg and 20mg. I'm seeing my primary care today and I'm also scheduled to see a hematologist because I probably have something else going on besides PMR based on my blood work. Tylenol did nothing for my pain and neither did ibuprofen. I have been my own advocate since October and I will continue to do so. I know I'm walking a fine line right now trying to balance everything, but six weeks ago I couldn't walk without a cane or do anything without extreme pain. This is nothing compared to where I was at the beginning.

I was diagnosed 2 months ago with PMR. Starting Prednisone dose 12.5.
PCP started decreasing dose. After 1 month dropped to 10mg and last week to 9mg. My pain has increased primarily in lower body but my joints in my hands have increased pain. I just had blood test and my inflammation markers are now in normal range. My PCP is satisfied but I am in pain. What is a good approach?

If the pain keeps you from functioning, then you need to relay that to your PCP. PMR is not a disease with textbook symptoms, markers, diagnosis and treatment. If your inflammation goes down on prednisone then it is working. Tapering down can be trial and error. Our doctors want us off prednisone as soon as possible because of what it does to us. You have to take some control over the tapering process. I was just this week asked to decrease from 25 mg prednisone to 20, even though 25 didn't fully relieve my shoulder pain but it was manageable. After four days, the pain returned to the point where I had to limit my activity beyond just the normal daily routine. That was Thursday night and I went back to 25. My rheumatologist is closed Fri-Sat-Sun. I have an appointment Monday. I will try 22.5 if he wants or else he needs to find something besides prednisone to relieve the PMR pain if he wants me off prednisone. I want me off prednisone because of the side effects I have, but I have to be able to function during the day.

If the pain keeps you from functioning, then you need to relay that to your PCP. PMR is not a disease with textbook symptoms, markers, diagnosis and treatment. If your inflammation goes down on prednisone then it is working. Tapering down can be trial and error. Our doctors want us off prednisone as soon as possible because of what it does to us. You have to take some control over the tapering process. I was just this week asked to decrease from 25 mg prednisone to 20, even though 25 didn't fully relieve my shoulder pain but it was manageable. After four days, the pain returned to the point where I had to limit my activity beyond just the normal daily routine. That was Thursday night and I went back to 25. My rheumatologist is closed Fri-Sat-Sun. I have an appointment Monday. I will try 22.5 if he wants or else he needs to find something besides prednisone to relieve the PMR pain if he wants me off prednisone. I want me off prednisone because of the side effects I have, but I have to be able to function during the day.