These are questions that I am still trying to answer after 9 months on prednisone. I started on 20 mg and had zero pain or symptoms until I got below 10 mg. Starting at 9 I had some pain throughout the day but not bad so continued my taper, dropping 1 mg every 3 weeks. I thought that this might be old pain that I have had for years coming back or just my body needing to start making cortisol again. By the time I got down to 6 mg I was in some serious pain and ended up having to go back up to 10 mg and start the taper again. This time I am down to 7 mg with a drop of 1 mg every 4 weeks. I hurt when I wake up in morning but feel pretty good when the prednisone kicks in after a couple of hours. If pain gets any worse than this I will call my rheumatologist and ask to either stop the taper or increase the dose again. My conclusion is that I should not ignore pain that the prednisone cannot control, ie lasts all day. A retired MD I know advised me not to ignore pain and other sx's of PMR because I'll just have a flare-up. I think he is right.

It took me 2 months of terrible mornings before someone suggested that I split the meds. I would suggest you try 10mgs in the morning and 5mgs in the evening. It was a game changer for me. My doctor said it was unorthodox but to go with what works. PMR is now in the “background “ and quite manageable.
Frank

No one wants to increase prednisone, but if you let the inflammation accumulate, you'll wind up with a flare. It may be that you need a higher dose (maybe 20 mgs) to achieve comfort. Once you are comfortable for a month, you can try to decrease slowly to find the lowest level of prednisone you need to achieve the comfort you experienced with your initial dose (provided your initial dose was enough to give you comfort). I had complete relief with 15 mgs. and some discomfort when I dropped to 12.5. I probably should have stayed there longer, but continued to drop 1 mg. at a time until I got to 10. I've been up and down from 10 over a year or more. Currently at 11-12. Everyone is different and you have to find what works for you. Slow and sure, but your body dictates your taper.

It sounds like you might need to go higher than 15mg for a while - until the pain is all gone. Then you can start tapering down - maybe a bit slower than you have been. Lots of doctors tend to stay with the 1mg per month taper. But for some of us, that is too fast or too much or both. You have to listen to your body. Only you know what you are feeling. But either way, if you start feeling pain again, then the taper is either too fast or too much.

As per @fjn's post, I too have tried splitting to daily dose - 10mg morning, 5 mg at bedtime (with a bit of food). Seems to have made a noticeable difference in my morning stiffness/pain. Goes against generally accepted wisdom, but you might like to give it a try for a few days.

I have been on prednisone about 2 weeks now, with the first week on 20 mg and this past week (and next week) on 15 mg, and a few weeks after with 10 mg. My limited experience has been some improvements during the week and "backwards steps" on or around the last 2 weekends. I'm still learning, and am hoping for symptoms to disappear, but have overall just seen a bumpy road the last 2 weeks, still far from symptom-free.