Hi Everyone, I have started reading your posts and feel so much better to know that what I'm experiencing in terms of ups and downs with PMR and prednisone are not unusual I was diagnosed in June and started taking prednisone in Sept. My doctor started me slow and ramped up in hopes that I wouldn't need 15 or higher mg. I ended up on 15 before the holidays and 20mg after. I ramped down from 20mg to 15mg 2 weeks ago and started have a flare up. It's better but not gone. I'm trying to decide if I should ramp up to 16 for a couple of weeks. Any advice? BTW...20mg caused me a number of problems and didn't really improve my situation much. I've never been on a blog before. I agree that just venting helps!

@aspine, I kept a daily log with the pain I was having in the morning along with that days dosage of prednisone so that I could discuss it with my rheumatologist. I used a pain scale of 1 to 10 with 10 being can't take it anymore and 1 or 2 is just a mild ache or stiffness and something that was OK with me. I did not taper down to the next level if the pain for me was above 2 and my rheumatologist was OK with the tapering taking longer. Also, if my pain was a 3 or 4 and above, I either went back to the previous dose of prednisone or split the difference by only bumping it up half of the previous dosage decrease. For example if I went from 7 mg down to 5 mg and the pain was bad the next day (for me a 3. 4 or above), I would increase the dose to 6 mg instead of going back to 7 mg to see if I could still taper just at a lower dose.

If it were me, I might try discussing the theory behind tapering off of prednisone with my rheumatologist and ask some pretty pointed questions like isn't the purpose of the prednisone to provide relief from the pain symptoms? ie...I take 20 mg and I feel great, but if I suddenly drop to 15, my pain level increases significantly and it's hard for me to function, etc. Here's some really good tips on planning a conversation with your doctor -- https://patientrevolution.org/visit-tools

I would also emphasize no two people are alike with their pain threshholds for PMR. There is a really good chart that you kind of have to read between the lines on tapering but when I look it, I see there's no timeline for tapering off of prednisone. There's only the goal to do it as soon as you can based on your symptoms.

Here's the article that the chart was pulled from under the Specific Recommendations Figure 1 -- 2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative: https://ard.bmj.com/content/74/10/1799

Do you keep a daily log with your pain and dose?

Find a new rheumatologist for sure! I had an experience similar to yours and in hindsight I wish I had bailed earlier! My first rheumatologist was like a bad mechanic throwing large doses of prednisone at me while my current rheumatologist is fantastic helping me navigate the nuances of PMR.