Hi @relauzon, Welcome to Mayo Clinic Connect. I'm not sure there is any "correct" way to taper off of prednisone since each of us are a little different. I had similar issues as you are having with my first occurrence of PMR. I worked with my rheumatologist who gave me several suggestions and when the pain came back I did what you did I went back to the previous dosage. I always tried to live with a little pain/discomfort unless it was too much for me. One of the things that helped me was reducing or increasing the dosage by 1/2 mg if the pain came back and it was really bothering me. I got the doctor to give me prescriptions for 2.5 mg and 1 mg tablets so it was easy to slightly increase or decrease the dosage when needed during the tapering process. I started at 20 mg dosage for both occurrences of PMR. The first occurrence took about 3 years to taper off with the last six months going back and forth between 1 mg and 1/2 mg until I was able to taper off of prednisone. The second occurrence I was able to taper off in about a year and half using the same tapering schedule.

Have you discussed your recent flare up and thoughts with your rheumatogist?

Hi Richard my name is Roland & what you went through & now going through it was the same with me. I will be turning 79 in a few weeks & my PMR came on 4 years ago in my shoulders, hips & neck started with 20 mg of pred. & tapered off. Now here it is 4 years later & I am on 1 mg/day due to my wrist & fingers hurting especially in the AM. I also was & still am in good shape working out, snow skiing riding my bike & gym work. Yes a strange beast but seeing there is at the moment no cure the only thing we can do is rely on prednisone & most important working out it helps not only staying in shape but it is much easier to deal with the pain.

Relauzon, my situation is similar to yours: I’ve reduced Prednisone from 40 mg to 3 over 15 months. The hand issue popped up at 3, and my rheumatologist has kept me there for 3 months, with the hand pain/numbness gradually fading. The key is the amount of Prednisone. A PMR support group in the U.K./Australia with many more subscribers details many stories of Prednisone reduction, and the general rule is to take just enough to control your pain. Lots of people try to reduce too quickly, causing flares and requiring moving back to a higher dosage and setting back the weaning process. There are published weaning schedules, but EVERYONE IS DIFFERENT. Remember that cutting from 2 mg to one is a 50% cut, while cutting from 20 to 19 is 5% even though both are 1mg changes. Thus, most people have to slow the weaning process the lower they go. Prednisone usually is better than PMR pain, so medicate accordingly. There are reports of patients on the U.K. site who have had PMR for 15 years and still take prednisolone. Others go fairly quickly to zero or very low doses. We are all different but adjusting dosages is key. I also have found that “motion is lotion” and even with morning pain, it dissipates if you exercise in moderation. With intense pain, only Prednisone helps. Good luck. You’re not alone.