I came down with PMR December 2021. My CRP marker was 58. Primary gave me Methylprednisolone 6 day pack starting at 24 mg, reducing by 4mg each day. Then finally I could see Rheumatologist in January who put me on 12.5 mg of Prednisone which I took at night (my decision) because the pain was so bad at night and morning I thought this would be better. It worked pretty well (pain level 3) except I was awake ’til 2am. 
I went for second opinion with new Rheumatologist this week and he increased my dosage to 20 mg and to take it in the morning. Now I am much worse again in the morning. Pain a 7. He is perplexed.

He did answer one of my main questions though: should we be treating PMR with Prednisone so that all pain and stiffness go to a Zero? - the answer is yes - getting to zero pain/stiffness is the goal and then to taper off the meds. So we are trying to figure out the right dosage for me. I am 121 lbs. He does not seem to want to go above 20 mg Prednisone yet. My CRP levels went from 58 (no meds) to 11 to 14 and now 17.

So since I had good results with the Methylprednisolone fast 6 day pack (until I hit 12mg), we are going to try going back on that medication now. I am taking 16 mg of Methylprednisolone each morning (this equates to 20 mg Prednisone). It's only Day 2. So far I am noticing it is working better for me than Prednisone but I am still achy in the morning (a 4- 5 pain level). I go back to see him next week and he said he is going to talk to me about potentially adding Methotrexate. But I want to ask why we don’t bump it up to 24 mg of Methylprednisolone because that worked for me originally. But he’s the expert.

Is anyone else using Methylprednisolone instead of Prednisone and noticing any difference or high success? How about Methotrexate?