Hi Christi, I too live in an area with a dire shortage of good specialists. My GP is good, but not well versed in PMR--few GPs are--and uncomfortable being the front line provider for it. I ended up finding a good neurologist about an hour away, and it made all the difference. (I had no luck finding a rheumatologist within a 3 hour distance.) My neurologist has a lot of experience with PMR because of its connection to GCA and has gotten the inflammation under control. If at all possible, I'd encourage you to try to find a specialist for PMR, even if you have to travel a bit. I realize that can be difficult in terms of work schedules, travel, costs, etc., but if you can manage it, I think you'll find it's worth it. I hope you get some relief soon.