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Urgent Question Regarding Prednisone Burst Dosage
Hello, I've had PMR for 2 years. After lots of struggles finally tapered to 5 mg daily. Currently on vacation hours from home, developed severe back pain radiating to both hips. Have had hip and shoulder pain with PMR but never back pain. Went to local ER, doctor prescribed burst of 40 mg pred daily for 5 days then back to 5 mg. My home rheumatologist advises against this. Wants me to go from 40 to 20 for 2 weeks then see her. I'm so upset! All my work tapering will be gone and have to start again. I'm tempted to just go back to 5 mg and see what happens! Would appreciate any feedback, thanks so much.
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I'm in a similar situation as @susiequeue . The ER started me on one of the 5 day packs where you start at 60mg and taper down. As soon as I got below 35mg the pain came roaring back; after 2 more ER visits, my neurologist put me back up to 40mg for 4 weeks, hopefully to begin tapering after that--from 40mg to 35mg to 30mg. In other words, *slowly*. It's a much higher dose than most people I've encountered here, and I really hate being on prednisone, but it's the only thing that has helped. IMO going from 40mg to 5mg at once is too much, too fast. The last thing you want is to bring on another flare. I think your rheumatologist is right, and she is surely more experienced with PMR than an ER doc. I hope you get relief soon.
I do emphasize with this roller coaster ride of PMR and prednisone. I Have been gradually weaning for the last six months and now down to 2 mg. I suddenly started having low back pain specifically in the sacroiliac joint area radiating down my leg. Typical SI symptoms. No other PMR symptoms but was initially concerned that it was a relapse. Doctor advised using Tylenol or ibuprofen and if that works then it probably isn’t PMR. Along with the appropriate stretching exercises and the Tylenol it works. Keep in mind that everyone is different and your rheumatologist knows you And the treatment plan that you should be on
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1 ReactionThanks for your helpful reply. I did jump down from 40 mg to 5 with no flare of the back pain. Started Tylenol and stretching and wow! No pain. Muscles tight but good when I stretch. I don't think it ever was PMR. Grateful for that! Thx again.