@jmcc - That's a great question. I based all of my tapering on a daily pain and dosage log that I kept when I started my taper from the 20 mg starting dose. I didn't taper down when it was time to taper down if my pain was above 1 or 2 when I woke up before I took my daily dose of prednisone. My first occurrence took me 3-1/2 years to taper off with the last six months going back and forth between 1 mg and 1/2 mg dose. I always had some stiffness when I first got up (still do!) so I didn't consider that part when tapering. Just getting up and moving around made a big difference for me.

You mentioned diet, exercise and rest are good. Just a thought, I could really tell when I overdid the exercise since my body would let me know about. I still worry about muscle atrophy and try to do more weight bearing exercises but I need to do more.

Here's some tapering guidelines from the British Society for Rheumatology:

"The British Society for Rheumatology guidelines suggests the following method for titrating the dose of prednisone in people with polymyalgia rheumatica:

-- Initial dose – 15 mg, once daily, for three weeks, followed by;
-- 12.5 mg, once daily, for three weeks, followed by;
-- 10 mg, once daily, for four to six weeks, followed by;
-- A reduction of 1 mg from the daily dose, every four to eight weeks"
https://bpac.org.nz/bpj/2013/june/polymyalgia-rheumatica.aspx
Do you keep a daily pain and dosage log?

Hi @jmcc I'm wondering if the pain in your shoulders is related to PMR or something else. I first had PMR, then Giant Cell Arteritis. Over the last six months, I've tapered from 40 mg prednisone to 7.5 mg. My CRP is slightly elevated, about 1.2 (down from 10.6) and virtually all of my pain is gone, except for my right shoulder. I have osteoarthritis, tendonitis and impingement. When the pain is very bad, occasionally, I take acetaminophen, on the advice of my rheumatologist, but I can usually tough it out. I have been going to physical therapy for the last four months and opted not to get cortizone shots to treat the shoulder. Very slowly, doing the exercises, my shoulder is getting better - less pain and slightly more range of motion.Shoiulders take a long time to heal. If you're concerned about atrophy, why not check in with a physical therapist for some gentle exercises? I purchased a shoulder pulley, which helps with range of motion exercises, and use an infrared heating pad (Thermotex) at night to relieve the pain in my shoulder. I hope this helps. All the best.