I'm expecting a call from my Neurologist today or tomorrow and I will ask him. He is trying to get me into a rheumatology clinic here in Halifax on an URGENT basis, but urgent here is end of May and that's not bad for Canada. My question for him is should I remain on the 20 mg until end of May or as long as needed, or what. All I do know is...everyday I notice something new which I was unable to do 2.5 weeks ago, such as reaching my arms back. Sometime there is still some sharp pain in my upper arms toward the back. My middle finger, right hand is still pretty stiff but the left hand is close to normal. Both hands had what appeared to be carpel tunnel and I wore splints on them for about 3 months, making my job impossible. Perhaps you do need a higher dose, but the second opinion is a good thing. Cheers ~ Deb