Hello @rachelp, welcome to Connect. I have had 2 occurrences of PMR. The first lasted 3 years at which time I was able to taper off of prednisone. Then it went into remission for 6 years and the 2nd occurrence lasted a year and half and I was able to taper off prednisone this past February. Methotrexate was never offered as a treatment for me by my rheumatologist but I certainly would have tried it the first time around as I really had a problem tapering off. Sometimes just a 1 mg drop and the pain would come back in my shoulders, arms, legs and hands with a vengence. I have no medical training or background but my guess is that pain is pain and I think it would be difficult to discriminate between the two. I did find a short article that talks about it being misunderstood (I think).