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How to address PMR pain while decreasing prednisone

Polymyalgia Rheumatica (PMR) | Last Active: Nov 6, 2023 | Replies (747)
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@deniseinca

Hi all i am loving this support network and wanted to ask a question, my symptoms increase about 3pm each day by bedtime my movement is difficult and exhaustion is real. My question is if you wake in the morning feeling OK but experience worsening symptoms in the afternoon evening would a CRP blood test show higher results in the evening versus the morning? Not sure if anyone knows but i normally have my blood tests first thing in the morning and the CRP level does not match the symptoms i feel. Thanks in advance

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Replies to "Hi all i am loving this support network and wanted to ask a question, my symptoms..."
John, Volunteer Mentor | @johnbishop | Feb 11, 2022

Hi @deniseinca, I think you are probably right, I'm not sure anyone can answer your question on the CRP levels morning vs evenings. Can you identify any activity or foods that could trigger worsening symptoms in the afternoon or do you feel worse even on days with not much activity? From what I've read elevated levels of CRP can indicate any type of infection or inflammatory condition. -- https://www.healthline.com/health/rheumatoid-arthritis-crp-levels

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Teri | @tsc | Feb 12, 2022

Hi @deniseinca - that's a little strange because PMR symptoms are generally worse in the morning and ease up a bit as the day progresses. You could try taking your next CRP in the afternoon to see if it's higher. There are some people on this site who split their dosage of prednisone in half - morning and late afternoon or evening (with food, of course). Maybe that would work for you.

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abbeyc | @abbeyc | Feb 22, 2022

I was having similar issue with 1
20 mg Prednisone and that’s why I took it at dinner time but my doctor said that’s wrong. But switching to the AM my symptoms got worse at night again. so he switched me to Methylpredisolone instead of Prednisone and it works like a charm. I am like a 0 to 1 pain level on 16mg. he said I am a very rare type that does not do as well on Prednisone so this may not be an approach for everyone. It will be a bit challenging tapering though because Methylpredisolone does not come in the small 1mg doses.

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