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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 didn’t do anything special. I continued to exercise and tried to reduce stress as I believe stress is what triggered my PMR (my major surgery and the illness and death of my mother at the same time).
I was on 40mg of Prednisone for GCA ,tapered down to 25 mg and relapsed.Had to increase to 40mgs .Am now at 20 mgms for a week and hoping to decrease to about 18 mgms tomorrow.Will check with my doctor in the AM.Once you reach 20 mgms is decreasing by 2 MGMs a week standard protocol to avoid complications. Thank you.
In reply to @portia and @rashida, I was diagnosed with PMR in February 2026, started on Prednisone 15 mg a day, but had to go up to 20 mg as incomplete symptom relief, and glad I did. Before diagnosis I had been seen by PT for L shoulder impingement and the symptoms kept getting worse, spreading to my right shoulder, and started feeling a lot of stiffness in my hips -- thought I was just getting older (I'm 76) even though very active, doing a lot of strength and flexibility workouts, until I could barely move in the mornings. Prednisone took care of all my pains, but the side effects... for me, more emotional ups and downs, and not able to stay on track with anything that required mental concentration. No weight gain til I started to taper down, so far only 5 pounds (but I was already what's considered overweight). My rheumatologist put me on Tyenne (tocilizumab, generic version of Actemra), in March, and I am now down to 2 mg a day of prednisone, with minimal side effects, and thank goodness emotions in check and brain concentration improved. However, even though my PMR is under control, my left shoulder impingement is coming back - PT warned me it might (that the prednisone was just masking the symptoms). What I have done in addition -- kept up flexibility and core exercises, using lighter weights till off prednisone, walking, swimming 4 times a week at the Y, a sauna every time I swim, acupuncture every 1-2 weeks. Who knows what has worked, just feels good to be throwing everything I can at PMR, and pampering myself, also grateful that I have decent Medicare plan, and access to at least phone and messaging with rheumatology. Also grateful for this website, and wishing the best to all others on this journey.
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3 Reactions@stonewheel I thought I was having a flare and upped to 20 for 2 days. It was awful! Thought I was going to die. Now, I think I didn’t have a flare but was tapering-off that was causing my hip/ arm pains and stiffness. I am at 1 mg now per Rheumy’s suggestion. Feel bad, stiff, hip pain, arm pain. I don’t think it’s my PMR. I feel like a Prednisone junkie… ☹️
@rashida Thought I was having a flare and upped to 20 mg. without checking bloodwork. ( As my rheumy directed). It was bad- hot flashes, couldn’t sleep, etc. Not doing that again without bloodwork.
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1 Reaction@gilbert56
Thanks for the update.
You’re not alone. Prednisone can be a love/hate thing.
It can feel like it is working a miracle, but like a deal with the devil, it makes one pay for it.
Your rheumatologist sounds good.
Your stiff hip and arm pain might be that your adrenals have not fully rebooted. Not working at 100%. They aren’t making your cortisol fully yet. I’ve read that the pain resembles PMR and it is difficult to know if it’s PMR or adrenal insufficiency.
My hips now get sore if I sit too long, not like PMR though, and when I stand my first steps require thought sometimes because of the soreness. Prednisone has probably eaten away at my bones and cartilage, plus every day I’m another day older.
Keep doing what you think is right and trust your rheumatologist if you agree with their plan. Ask them for clarification. And, ask them what their end-goal is for you.
Sorry for the long reply.
Movement, sleep, water and healthy food.
@slh317 I guess you are proof that medications are body specific … what works great for one person does not for another. Wish all medications affected all people in the same positive way! My body is hypersensitive to so many medications.
@jabrown0407 I wonder if Prednisone and Prednisolone are the same drug … recently I had a minor laser eye procedure and was prescribed Prednisolone eye drops. The very first dose (just one drop!) caused such dizzyness I had to stop taking them! I couldn’t walk straight after that first one drop dose!
Please Google this question or if you use an AI tool ask it. They are related for sure but the technical details are best described by a web tool.
Remember you could be reacting to the compounding agents and not the drug itself. I am especially sensitive to drugs and without question it is most often the compounding ingredients.