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Day 4 of prednisone and happy! Stay at 15 or go up to 20?
Greetings! First post (yay!). Finally got a treatment plan exactly a year after first hearing of PMR (and lurking here). Delay caused by other health issues (see below). This week started on 15 mg prednisone with instructions to increase to 20 mg after 3/4 days if I didn't get relief.
I started feeling relief in about 3 hours, and after two days my cement shoulders were largely gone, my hips have loosened, and my fatigue has lessened. But it's confusing; like may of us, I have a slew of other muscle issues. Specifically:
Over the winter I had a flare up of a crushed nerve root issue; treatment was successful but it leaves my hip and leg muscles a mess, with slow (months-long) rehab. Also had a prolapsed biceps tendon last year that messed up my left shoulder (two problems that keep me from raising my arm, yay!). The amount of home PT I do is insane. And my sense is that the PMR made rehabbing these injuries extremely difficult, with limited results (though I am currently reaping the benefits).
So now, starting day four, I'm feeling all of the old injuries in a more pronounced way--as if, with most of the PMR pain removed, they've reared their heads to demand attention. I'm happy to provide that, of course, but it is just a bit hard to tell what the heck is what in my left shoulder, left hip, and left leg.
So it's hard to judge exactly how successful the 15 mg dose has been. I'm thinking at least around 60% better? Maybe 70%? It's great, whatever it is, but I can't quite decide if I should stick with 15 mg or go up to 20. I'm thinking, this is my chance, don't blow it. Any thoughts?
A bit more about my PMR. Pretty classic morning stiffness, shoulders lately unusable, fatigue. ESR topped out at 104; CRP at 32 mg/L in January; about half that now, for whatever reason--maybe doing Mediterranean diet and upping the antioxidents. I'm gonna be 73 next month. 🙂
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I am 70 and was diagnosed with PMR 11 years ago. Prednisone helped for flares during that time. Last year, I was having trouble with pain and asked my PCP if I could start on a daily dose. Pain got better, but I started with muscle stiffness all over. Now, I am trying to taper-off prednisone and it has been hard. I made the mistake of thinking it would make me feel good and have energy like it did at first. Now, I think a lot of my issues are from prednisone itself. Try to avoid the merry-go-round, if possible. Really, the only thing, besides prayer that makes me feel better is coffee! But, you have to be careful with that interfering with your sleep. I’ve been a big coffee-drinker for years, so it has actually helped me rest, probably because it lessens the pain. I actually sleep better drinking it, but if you don’t normally drink it, it can keep you awake and interfere with restful sleep. Google “PMR and coffee”. There is actual a basis for the pain relief. Walking has helped, and vitamin supplements( check with physician first). Also, I’ve noticed issues during weather changes. Keep a journal and see if you notice any patterns….
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4 ReactionsWork with your rheumatologist to sort out your symptoms. It is possible to have PMR presage or morph
into to other rheumatologic diseases.
My treatment taper to complete remission then developed into psoriatic arthritis.
Your inflammatory numbers are quite high so be aware
of the symptoms of temporal arteritis. Discuss the cardiovascular risk of systemic inflammation with your doctors. Mediterranean diet is very important. Keep following the lab numbers. Short answer is why not try 20 mg for a week?
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3 ReactionsPrednisone can lessen all inflammation, not just PMR. I started at 15mg prednisone when the extensive blood work of my rheumatologist showed inflammation, but as more results came back I was diagnosed with PMR. I wasn't getting any relief on 15mg so it was increased to 25mg. Now that I'm tapering down due to a subsequent SMM diagnosis, I am feeling all the other osteo arthritis that I didn't realize was also being suppressed by the prednisone. If you're not getting full relief at 15mg try 20mg. Tapering back down to 15mg isn't the hard part of tapering. Doing 2.5mg decreases I didn't feel it until I came down to 12.5mg.
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3 ReactionsYou might try 20 for 3/4 days. If it masks your non PMR pains you have your and. I have a lot of Prednisone side effects at 20 that don't show up at 15, another thing to be on the lookout for. No single right answer, as you know by now.
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3 ReactionsWelcome and greetings back to you.
Rehabbing the others while with PMR, must be tough.
Don’t stop though. I think rehab exercise on my shoulders (both replaced), back, and left knee (needs replacement) are helping with my PMR.
Don’t take more Prednisone than you need, but take what you need. Not any more than absolutely necessary.
I agree with the other replies, if you feel that you must, try 20 for 3-4 days. Tapering 20 to 15 is not difficult. The more Prednisone that you take and the longer you take it, the harder it is on your body.
Best wishes.
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3 Reactions@portia I would not change the dosage without talking to the prescribing doctor.
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5 Reactions@seniormed Thank you--that is most helpful!
@jabrown0407 Thank you. That helped be decide to stick with the good and no pursue the perfect.
@stonewheel Thanks; I heed your (and others) warning about the future.
Thanks, all. Your feedback is immensely useful.
I decided to stick with 15 mg, since results are very good and side-effects nonexistent.
And I learned I must think about and plan for the future now. So glad to have this board as a resource.
Excelsior.
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