PMR Dosages and Managing Symptoms

Hi @kimberlynitz66, Welcome to Connect. Tapering off of prednisone for PMR can be very difficult and needs to be slowly. Usually if my pain symptoms returned when I had tapered down, I tried upping the dosage by half of the previous taper so it was still less than the previous dose. Each of us are different but I think you are still early in your PMR being diagnosed in March. The first my PMR came out it took me 3 and half years to taper off. The second time 1 and half years. You will notice that we moved your post to an existing discussion on the same topic here:

-- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/

You might want to jump to the top of the discussion by clicking the link above and read through the posts of what others have shared to see if anything rings a bell for you. Do you keep a daily pain log and dosage to help you keep track of your tapering?

Hi Everyone,
I am new to the group and was diagnosed with PMR by my rheumatologist in May. I also have degenerative disc disease and really thought my new hip pain was a consequence of the progression of issues with my lumbar spine. My CRP and Sed Rate were both crazy high and that convinced both myself and my ortho that something else was happening. I have had minimal shoulder pain but have had significant neck and upper back pain & spasms. My question is that my initial dose of prednisone brought immediate relief at 15 mg but within about 5 days the pain returned. My dose was increased to 20 mg but I have not had the kind of complete relief that I felt originally. Should I expect to be pain free or just better than I was? I am experiencing some side effects from 20 mg so I am reluctant to increase the dose but I would also like to do what I can to facilitate remission. Your comments have been so helpful and I am thankful to have found this resource. Blessings!

I had COVID with mild symptoms in late December and soon after began having symptoms of muscle pain, general malaise, etc. I was diagnosed with PMR by a rheumatologist in early April. I was given 60 mg of Prednisone in the hospital for 2 days in a row. It was miraculous, and my debilitating pain disappeared. I went home on 30 mg of Prednisone and now am at 15 mg. My rheumatologist seems to think everyone responds to Prednisone in the same way. He has a program that he thinks everyone needs to follow. I tried to taper to 12.5 mg, but the pain was too severe. I am back to 15 mg and rheumatologist wants me to taper again to 12.5 mg. after two weeks at 15 mg. I would prefer to taper by a smaller amount, but he said we don't do that. I need to be at 10 mg before tapering less than 2.5. He did agree that if the tapering by 2.5 does not work this time, he will consider tapering less. I want to get off Prednisone more than he wants me to get off. But I am confused about how much pain is acceptable. Currently when I get up in the morning I have pain in hips, shoulders, arms and hands. It can be hard to stand from a sitting position, but I can tolerate the pain. Rheumatologist says neuropathy in hands and feet is not PMR.

Hi @sandiw77, Welcome to Connect. There are different conditions that can mimic PMR with similar symptoms and it can sometimes be difficult to diagnose. From my experience with 2 occurrences of PMR, after taking the first dose of prednisone in the morning, I was pain free within a few hours. I was usually good until the morning then would be a little stiff with a few aches until I started moving around and took the next dose of prednisone. I kept a daily pain log with the amount of prednisone I took that morning. When I started tapering, I wouldn't taper if my pain scale was above a 2 or 3. In those cases I sometimes upped my dosage by 1/2 of the previous taper to try and keep my taper going.

My second time around I started eating better and exercising a little more which I think helped me taper off sooner that the first time with PMR. Here's some information that might be helpful:
-- Can Diet Affect Symptoms of Polymyalgia Rheumatica?:
https://www.healthline.com/health/polymyalgia-rheumatica-diet
Are you about to discuss neck and upper back pain & spasms with your doctor or rheumatologist to see if they may have some thoughts on if it's related to PMR or not?

I had COVID with mild symptoms in late December and soon after began having symptoms of muscle pain, general malaise, etc. I was diagnosed with PMR by a rheumatologist in early April. I was given 60 mg of Prednisone in the hospital for 2 days in a row. It was miraculous, and my debilitating pain disappeared. I went home on 30 mg of Prednisone and now am at 15 mg. My rheumatologist seems to think everyone responds to Prednisone in the same way. He has a program that he thinks everyone needs to follow. I tried to taper to 12.5 mg, but the pain was too severe. I am back to 15 mg and rheumatologist wants me to taper again to 12.5 mg. after two weeks at 15 mg. I would prefer to taper by a smaller amount, but he said we don't do that. I need to be at 10 mg before tapering less than 2.5. He did agree that if the tapering by 2.5 does not work this time, he will consider tapering less. I want to get off Prednisone more than he wants me to get off. But I am confused about how much pain is acceptable. Currently when I get up in the morning I have pain in hips, shoulders, arms and hands. It can be hard to stand from a sitting position, but I can tolerate the pain. Rheumatologist says neuropathy in hands and feet is not PMR.

I had COVID with mild symptoms in late December and soon after began having symptoms of muscle pain, general malaise, etc. I was diagnosed with PMR by a rheumatologist in early April. I was given 60 mg of Prednisone in the hospital for 2 days in a row. It was miraculous, and my debilitating pain disappeared. I went home on 30 mg of Prednisone and now am at 15 mg. My rheumatologist seems to think everyone responds to Prednisone in the same way. He has a program that he thinks everyone needs to follow. I tried to taper to 12.5 mg, but the pain was too severe. I am back to 15 mg and rheumatologist wants me to taper again to 12.5 mg. after two weeks at 15 mg. I would prefer to taper by a smaller amount, but he said we don't do that. I need to be at 10 mg before tapering less than 2.5. He did agree that if the tapering by 2.5 does not work this time, he will consider tapering less. I want to get off Prednisone more than he wants me to get off. But I am confused about how much pain is acceptable. Currently when I get up in the morning I have pain in hips, shoulders, arms and hands. It can be hard to stand from a sitting position, but I can tolerate the pain. Rheumatologist says neuropathy in hands and feet is not PMR.

I had COVID with mild symptoms in late December and soon after began having symptoms of muscle pain, general malaise, etc. I was diagnosed with PMR by a rheumatologist in early April. I was given 60 mg of Prednisone in the hospital for 2 days in a row. It was miraculous, and my debilitating pain disappeared. I went home on 30 mg of Prednisone and now am at 15 mg. My rheumatologist seems to think everyone responds to Prednisone in the same way. He has a program that he thinks everyone needs to follow. I tried to taper to 12.5 mg, but the pain was too severe. I am back to 15 mg and rheumatologist wants me to taper again to 12.5 mg. after two weeks at 15 mg. I would prefer to taper by a smaller amount, but he said we don't do that. I need to be at 10 mg before tapering less than 2.5. He did agree that if the tapering by 2.5 does not work this time, he will consider tapering less. I want to get off Prednisone more than he wants me to get off. But I am confused about how much pain is acceptable. Currently when I get up in the morning I have pain in hips, shoulders, arms and hands. It can be hard to stand from a sitting position, but I can tolerate the pain. Rheumatologist says neuropathy in hands and feet is not PMR.

I had COVID with mild symptoms in late December and soon after began having symptoms of muscle pain, general malaise, etc. I was diagnosed with PMR by a rheumatologist in early April. I was given 60 mg of Prednisone in the hospital for 2 days in a row. It was miraculous, and my debilitating pain disappeared. I went home on 30 mg of Prednisone and now am at 15 mg. My rheumatologist seems to think everyone responds to Prednisone in the same way. He has a program that he thinks everyone needs to follow. I tried to taper to 12.5 mg, but the pain was too severe. I am back to 15 mg and rheumatologist wants me to taper again to 12.5 mg. after two weeks at 15 mg. I would prefer to taper by a smaller amount, but he said we don't do that. I need to be at 10 mg before tapering less than 2.5. He did agree that if the tapering by 2.5 does not work this time, he will consider tapering less. I want to get off Prednisone more than he wants me to get off. But I am confused about how much pain is acceptable. Currently when I get up in the morning I have pain in hips, shoulders, arms and hands. It can be hard to stand from a sitting position, but I can tolerate the pain. Rheumatologist says neuropathy in hands and feet is not PMR.