The answer is that too many people don’t take enough Prednisone to kill the pain. We’re all different and the beginning dose that is required takes a bit of trial and error. No one wants to be on Prednisone, but it sure beats PMR pain. The general rule is to take as little as possible that controls the pain and then taper from there VERY SLOWLY. Everyone is different about tapering also, but rheumatologists sometimes urge patients to cut back far too soon. The actual median time for “clearing” PMR and Prednisone use is reported to be over five years by a support group in Europe with over 11,000 members. When you get to 10 mg or less, the tapering should be by 1 mg or even 1/2 a day and it requires some time (up to a month) to know if that level is still knocking out the pain. Prednisone does have many known side effects and isn’t to be taken lightly, but we are fortunate to have such a powerful weapon in our arsenal because nothing else touches PMR pain.