@skiing I think I remember having a few similar flares during my first round with PMR that when I had been on a dose of around 10 mg and felt pretty good. I overdid some activities during the day and I felt worse the next day. The first time I didn't put 2 and 2 together but the second time it happened I started listening to my body a little closer and tried not to overdo any activity/exercise. @jmcc, @tsc, @kmeikle1, @milld835 and others may have some thoughts or suggestions for you.