Has anyone had steroid shots in their shoulders for PMR?

PMR is a chronic inflammatory problem. Steroids are the classic anti-inflammatory drug that is effective. The goal is to be on the lowest pain free dose needed. Then the next goal is for your body to go into remission. That means you can taper successfully. You can not "make your body go into remission". That will happen when and if your body does it.
Many people can taper to zero and remain pain free, thus they are in remission.
Once you see a rheumatologist they will have a strategy they prefer to have you try. I would say to find the lowest pain free dose until then and stay there.
You might start a daily pain log of pain morning, afternoon and night, where it hurts and levels of pain. That way you don't have to rely on just your memory.
I hope you are taking your steroids all together in the morning and not splitting them during the day.

@jabrown0407
Thank you for the good advice. I do take my meds in the morning and started with 3mg instead of 1. Do you adjust your prednisone when you need or wait for your doctor to decide? I started at 40mg and my doctor said to just start tapering and never mentioned not when it feels better but every few weeks.

I use how I feel as well as the results of recent CRP and Sed Rate test to assist in the decision making process.
My Rheumy uses only how you feel and historically that has failed me.
If I have any pain that cannot otherwise be identified, like osteoarthritis, I do not taper.
And if either of my inflammatory markers are outside of normal I do not taper.
I review the status every 30 days. My PCP is running monthly labs for me. I am at 7 mg prednisone currently. Below 10 I will only do 30 days. I want to give my body the time it needs to adjust to each taper. My endo is good with anything below 10.
Tapering is used to help determine if you have gone into remission as well as to monitor adrenal recovery. Tapering is an art and not just a science. One size does not fit all.
Remember, PMR is a default Dx and they do not fully understand it. This means that treatment protocols are not mature.

Thank you.

@jabrown0407
I regards to splitting dose: I would like to hear your opinion.
I just got diagnosed by Rheumatologist 7/31/26, after suffering brutal pain in shoulders, upper back, upper arms and fingers, stiffness, weakness in upper arms, stiffness in legs after sitting that made it hard to walk. The pain was so brutal and woke me up every single night since Mid-March. About 2am it rears it's ugly head and I had to get out of bed and go sit upright on couch to lessen the pain a little. Sleep on back due to small rotator cuff tears (73 yrs). Started on 15mg Prednisone 7/31 and got significant but not complete resolution of all symptoms. My left shoulder, upper back, upper arm, and fingers still wake me up. After 5 days @15mg, I let my Rheum know and she upped my dose to 20mg. It still hasn't resolved the left upper body pain/waking me up/ nor pain that lasts well into the day in left arm. (Since 8/5/26, today is 8/13). Everything is so much better though, that it's a blessing. I messaged my Rheum again 2 days ago (8/11) and let her know 20mg still not resolving left side. She said "Split the dose, take 15mg am and 5mg later in afternoon/early evening. I tried 5mg at 4pm first day(too late I found out). Couldn't sleep from Pred and no change in pain or it waking me up. Yesterday took 5mg at 1pm. Still couldn't sleep and still no change left side.
I've been so sleep deprived for 4 months that it's hard to even want to continue splitting one more day. My gut feeling is that in my case, I might need a higher initial dose to get complete relief. I read somewhere it said 30mg sometimes necessary to start with some cases. My pain was brutal and incessant. My symptoms lasted all morning for about 4-5 hours after I'd wake up. I'd have to just sit on couch or at table and try to move around a little, drink coffee and water and gently try to move upper body, legs, hands/fingers. My case/pain/symptoms are slightly different from others but definitely PMR confirmed by Ultrasound. What do you think re splitting doseage and have you heard of people needing higher does initially to get full relief? Thanks so much.

@boomermeg I am not a doctor nor do I have professional medical training. Please continue to stay in touch with your doctor on changes to prednisone dosing. You can certainly request some approaches and one I might suggest is to try 40mg for 3-4 days then 30mg for 3-4 days then 20 to see if that kicks the pain. You are possibly getting into the dose level where it is the prednisone keeping you awake and not so much the pain. At 20 mg I have trouble sleeping.
Have you had your inflammatory blood markers tested? I now use the blood work as well as how I feel to help make treatment decisions.
As for splitting a dose, I've never done it and I really can not comment. I do know it works for some people on this site.
Another comment is it is my understanding that if you need more than 20mg daily to knock the pain that they now believe you may have additional problems at play.
I didn't take the 40mg daily that was initially Rx for me in 2020 because I was scared and because my rheumatologist stepped back from practicing due to COVID. COVID and it's restrictions helped me hide my problems because no one was able to get out and about.
Another option would be for you to ask your rheumatologist to explain the strategy they are using to find the "just right" dosing target. Possibly if you better understand their approach you can better work as a team. I suspect the doctor would welcome the dialogue.
I wish you success on getting ahead of the pain and being able to get a full night's rest.

@jabrown0407
Thanks so much for answering. I do appreciate that you're not an MD, but speaking with people who've been dealing with all of it helps. No, it's not the early AM prednisone that's keeping me awake. I'm so sleep deprived and I have sleep apnea and already have had chronic pain and pain medication for many many years. I have 2 cervical vertebrae fused and have a lot of chronic muscle spasm in my upper back. But I've been able to fall asleep the minute my head hits the pillow for years. My husband often has to remind me to put my CPAP mask on. It's the early AM pain wakes me up and has nightly since Mid-March, as I've read it does for many. (Around 1:30-2am usually). This isn't pain I've ever had before. Always originates in both shoulders and top girdle of upper back.,into upper arms and hands. Before the Prednisone I also had horrible swelling like sausages in fingers of both hands and some nasty wrist pain on left. That swelling is gone in both since Prednisone but not some left hand stiffness and pain. Not my usual neck/upper back pain. It's completely different and the intensity was brutal before Prednisone.
What has kept me from sleeping at all the past 2 nights is the split. (15mg 7:30am, 1pm 5mg).
Prior to Prednisone and even the first few days, since Mid-March, the pain is what wakes me up every night.
Upper back girdle and shoulders are where the worst pain is that wakes me up. I've been having to sleep on my back since Mid-March due to a small rotator cuff tear on right side(-all right side shoulder pain and symptoms are gone, as is the rest of my bodies pain & symptoms), but also have had a lot of old issues on my left side, that's true and my Rheumatologist is aware. But this pain is ,has always, and still is starting about 2am, just as I hear PMR does., then lasts into the morning and gradually eases. I've had to get upright and go sleep on couch sitting up since Mid-March (prior to Prednisone). The pain didn't go away, but it was a bit more tolerable sutting upright with pillows under my arms. I had the weakness in upper arms and couldn't lift them. That's been gone since a few days at 15mg.
The left side pain continuing may definitely have some other problems behind them but the type of pain/symptoms are totally PMR type. I had CRP and ESR elevated, my iron saturation was 9, my regular iron was 24 or so, ferritin was 178 originally. My RBC, etc were all low. Had to start IV Iron, Venofer. Have one more I next week then done with the 5 IV's.
I do CRP,ESR,IRON, CBC, A1C, D3, and some others I can't remember tomorrow morning. I agree that's a good gauge for us and the Dr.
The 40mg,30, back to 20 is interesting idea. I agree, and have been messaging my Rheumatologist regularly through our medical portal. I'll have my 2nd visit 9/4. I do need to ask her what her dosing strategy is though. Great question. Thanks.
This disease is the most difficult, painful and longest lasting (due to Dr's and I not knowing what it was until many different combinations if blood tests), that I've ever experienced and at 73 with osteoarthritis and bad spine, multiple surgeries, that's saying a lot. I think the sleep disturbance has made it so much harder too. It was my NP ordering the Iron saturation, CRP, ESR, Ferritin, CBC all at same time that lead me to search online and found PMR matched my symptoms better than anything else I'd looked at. That's when I asked to get on Rheumatologist cancelation list. Got in next day!! Miracle. She examined me and confirmed PMR But ordered an Ultrasound the next day. It confirmed PMR but thankfully, no GCA. Sorry this is so long but maybe it'll give some information to someone else as well.
Thank you again for your input. It is very helpful. Grateful for this support group. Blessings to everyone.

I have low hemoglobin and high blood ferritin. The second hematologist I saw Dx anemia from a chronic disease. The transfusion is my only available treatment. Have not needed it yet. Hemoglobin sits close to the lower limit. This causes some of my fatigue. I have been told to limit eating high iron foods like liver, spinach, kale, etc.
While on the subject of food. I would suggest to stop eating refined sugar and carbs. These only provide food for the inflammation beast. You can also research anti-inflammatory diets.

@boomermeg Hey JAbrown i feel your pain. I'm greg in California. Got diagnosed with PMR in February. Been on Predinose since starting at 15 mg and now at 5 mg. It's a battle. I feel prednisone alleviates the pain but is not the answer. Prednisone is not good for you in the long run either. I feel all these Auto Immune diseases are caused by a leaky Gut. I've gone Gluten free, stopped drinking Alcohol, Taking A good Pro Biotic helps the gut. Try to do less sugar and avoid processed foods. The Rheumatogist I have never suggests these important things. You have to be an advocate for yourself. Your body needs rest but also find time to do some fitness. I find hitting the swimming pool helps me stretch out. I also see a Accupuncturist which helps take out the inflammation and Arthritis. I also find that walking and running stairs help me especially when im warmed up. Getting in a crouch like a catcher in baseball helps.
My PMR came on when i injured my shoulder doing bench press at the gym. I then found out i had tears in my rotator cuff also. I'm debating whether to suck it up and not do surgery. I'm 70 in September. Keep in touch, Greg

@geese1
It's very true re our "gut microbiome " health and just how much difference it makes in our health if we "feed" it properly and help it thrive.
You sound like you're in fantastic shape in terms of your physical fitness and abilities to do all kinds of great activities. I'm not where near that. But, I'm doing what I can as I get improvement. It's been so debilitating for so many months in addition to the stiffness caused by sleeping upright on the couch for months has made for a lot I have to get "worked out." Food is huge. What we eat should be thought of as "let thy food be thy medicine, and thy medicine thy food!"
I stopped eating all sugary treats etc because of the inflammation it caused me a long time ago, plus knowing how bad it is for us. I try to eat organic as much as possible and eat well. I'm dealing with so many other health issues at the same time it's compounded. I have bad knees (osteoarthritis and meniscus tear/surgery) and had Baker's cysts behind both knees that ruptured in May.
As well as all my spine/chronic pain neck, sleep apnea and multiple other things.
So, this added on top of all that. But if there's a will, we can try to find a way. One day at a time with God's help and the support of eachother. Thanks for your encouragement. May you feel better too.