@joeblo746, If the 20 mg doesn't get it done for you it's time to have a serious chat with your doctor and possible seek a second opinion from a rheumatologist. We are all a little different and there are some conditions that mimic PMR symptoms which can be hard to diagnose.

-- Diseases that mimic polymyalgia rheumatica (PMR): https://www.medicalnewstoday.com/articles/diseases-that-mimic-polymyalgia-rheumatica

Members that have had Giant Cell Arteritis (GCA) along with their PMR generally have to start treatment at a higher dosage of prednisone than what a lot of primary care doctors consider the standard dose of 15 to 20 mg prednisone.

Can you ask your doctor for a referral to a rheumatologist?

I'm so sorry to hear this and completely sympathize with your situation. 40mg is definitely a higher dose, but it works, and I'm hoping to be able to step down soon. If 20mg isn't working for you, I agree with others that you should definitely try to see a new doctor/rheumatologist. From what I've learned, too many doctors are overly fixated on reducing steroid use at the expense of pain--and pain equals inflammation, so they're not actually treating the PMR if they don't eliminate the inflammation before starting a taper. The side effects are pretty miserable, but frankly I'd take them over the pain any day. Good luck to you and I hope you find relief soon.