PMR and preexisting knee pain

@oxzab I have had right knee pain over the years but certainly not steady. It started about 20 years ago . It would cause me limping for a week or m maybe two, but then disappear for a year or several years. X-rays showed a small piece of knee cap bone was detached and I should do nothing about it, as it must have happened from a fall as a young girl. The detached piece had been smoothed over after many years. In October, 2024, I had very bad pain in my knee. I was diagnosed with a torn meniscus but it was not severe and surgery was not recommended. I had a cortisone shot in my knee and all was well. About 1 month after the cortisone shot in my knee I developed bilateral pain in my shoulders, upper arms and thighs, hence, PMR. I had to cancel a trip to Patagonia. Since December 2024, I have been on methylprednisolone and have had a nice year of tapering with no real flareups. For the past 2 weeks I have been down to alternating 2 and 1 mg per day as it is not possible to have a methypred pill less than 4mg (pill slicer can only accomplish up to 1 mg). I did develop some discomfort in the back of both knees. By the end of the 2nd week of this taper, my right knee pain came back with a vengeance. I know from previous MRI and x-rays, I do not need a knee replacement. I believe my knee pain is my flareup. It did accompany very mild pain in in my shoulders. It is now the 4th day that I returned my dose to 2mg/day and am getting some relief in my knee. There are no symptoms in my shoulders. As everyone seems to find out, getting OFF of prednisone is a real challenge.

@aisp3b

I'm curious why your doctor prefers methylprednisolone instead of prednisone as is standard for most US patients. Prednisone, as I understand it, is less potent and comes in more flexible dosage amounts of 1mg, 2.5mg, 5mg, etc pills. Whereas methylprednisolone comes in 2mg, 4mg etc pills. Prednisone just seems a lot more flexible for tapering.

I have osteo arthritis in both knees. Before PMR it would flare during weather change or with overuse. Since osteo arthritis is inflammation, when I started taking prednisone my knee pain decreased dramatically. Now that I am tapering down on prednisone (having gone from 25mg to 15mg) I am feeling the old knee pain again, especially because we've had quite a bit of rain over the past week. It's going to take time to adjust back to the knee pain but I'll take it over the PMR pain any day.

@kjoed53 I have had a similar experience. I took methylprednisolone for my PMR meds. I believe they certainly helped mask my knee pain. I will eventually need a knee replacement but the knee is just not ripe enough for replacement surgery. I am now done with my PMR meds. My knee discomfort is more prevalent. What I find very helpful is Volteran. I buy the generic brand, much cheaper. Costco sells the generic as do some pharmacies. In the evening, rather than use the generic Volteran again, I put Tiger Balm on my knee since that is all natural. I'm doing pretty good. Two weeks ago I was in Spain on a tour doing much walking all day. It was a bit tough on my knee but I continued my routine of Volteran/Tiger Balm. I also added 2 extra strength Tylenol pills. I managed pretty well.

@barjohnson62 I was unable to get an appointment with a Rheumatologist when I was stricken with PMR. No one offered me any meds. I was desperate and I diagnosed myself by typing in my symptoms on Google. My Google answer was PMR and Pred was the solution. I was extremely desperate for help and I had in my house the Medryl 6 day Pack which is Methylprednisolone (I had intended to take the pack with me for a bad knee on my vacation to Patagonia). I took the methylprednisolone (3 4mg pills). I was brand new within 1 hr. By the following week I saw a rheumatologist who gave me the script to prednisone. I stated at 20mg on pred but it did not work as well as the methylpred so the rheumatologist prescribed the methylpred and that is what I used for my PMR journey. I did rally great and tapered slowly. Each time I decreased, I had no PMR symptoms. I started on methylpred at the end of December, 2024 at 15mg. I just finished taking it 4 days ago (May 23, 2026) and never had a flare on my journey down to zero. So far so good, no PMR symptoms.

Yes, similar. I experience more PMR symptoms in places that have had a previous injury. Not perfectly bi-lateral.