Yes, there does seem to be relationship between moderate exercise and increased PMR symptoms with lower doses of prednisone. I guess the explanation is that exercise causes inflammation. I started on 20 mg of prednisone in August of 2021. I had gone 4 months without a diagnosis and had backed my activity level way off due to pain. Suddenly I could do whatever I wanted again: 8-9 mile hikes with 1500 feet of elevation gain, bike rides up steep hills, birding carrying a telescope and gear 3-4 miles. There was no pain and no after-effects. This was true until I got below 10 mg when I began to have increased symptoms with activity. Below 8 mg I really ran into trouble. My rheumatologist told me to hold on 8 mg for awhile. I'm continuing my preferred activities but not hiking and walking as far and slowing everything down. I feel that I need to do this to continue the taper. I am taking a trip next month and will not drop my dose until I get back. If you are like me, 15 mg will allow you to really enjoy your trip!

Hello @denise23, Welcome to Connect. You will notice that we moved your post into an existing discussion on the same topic here - PMR and exercise: What helps you?: https://connect.mayoclinic.org/discussion/pmr-and-exercise/ so that you could connect with @jcaffrey47, @tsc, @cgent, @zaa and others.

The key thing I've learned from my two occurrences of PMR is that exercise is important and I feel better when I get 30 to 60 minutes a day of exercise in but I also have to make sure I don't overdo it. Even though my PMR is in remission, if I do too much exercise, my body lets me know the next day. I have Teeter FreeStep exercise bike that I try to use for 30 to 60 minutes a day along as part of my exercise routine.

The Arthritis-Health site has some good strategies for copying with PMR here: https://www.arthritis-health.com/blog/3-strategies-coping-polymyalgia-rheumatica-pmr

You might also want to keep a daily pain log along with how much prednisone you took that day. I never tapered when it was time unless my pain level was a 1 or 2 on a scale of 1 to 10. Do you keep a daily pain log?

My first bout of PMR occurred fourteen years ago at age 62. At the time, I had decided to intensify my exercise program from a simple walk in the evening to a more vigorous regimen of power walking and stair climbing at the local high school track and football stadium. Not very long after I began this program I was struck by incapacitating pain in my neck, shoulders, hips and legs, which I believed was brought on by the increased exercise. After various doctor visits and months of prednisone treatment, the PMR resolved and I was able to resume a milder exercise program. I remained in remission until 2021, when, after my first Covid vaccination, I experienced a second debilitating flare of PMR and was treated again with prednisone. After months of treatment, I finally achieved remission again and was able to discontinue the prednisone. The rheumatologist's parting advice to me was to avoid intense exercise, especially stair climbing. I am now 76 and have remained in remission from my latest flare for one year. My exercise regime consists of thirty minutes of daily walking at a moderate pace.