PMR Dosages and Managing Symptoms

Posted by maryft @maryft, Aug 16, 2021

I've read through the discussions and note all the different dosages of prednisone, different lengths of time taking prednisone, plus the addition of other meds, for PMR. I also note that the tapering of dosages and time frames are so varied from person to person. It appears there is not a set standard among physicians. How does one know if they were/are receiving the right dosage? Obviously, if symptoms subside, the dose is working, but after tapering if the symptoms return, was the initial dosage correct? I've also read that a person shouldn't be on prednisone long term, but there are many who've been on it for a few years. Its all very confusing.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

@issyb

I was just diagnosed with PMR and the first available rheumatologist appointment isn’t for a month and a half. My GPS has me on 10 mg of prednisone after coming off of a six day pack.
The 10 mg seems to be working except I’m a little stiff and sore in the morning but other than that I’m OK.
I’m a little concerned that my appointment is so far out do you think 10 mg is OK for me to stay on until I see the rheumatologist

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Thank you so much for your encouraging and timely response.
It means so much to me to have this group ..
hugs 🤗

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@issyb

I was just diagnosed with PMR and the first available rheumatologist appointment isn’t for a month and a half. My GPS has me on 10 mg of prednisone after coming off of a six day pack.
The 10 mg seems to be working except I’m a little stiff and sore in the morning but other than that I’m OK.
I’m a little concerned that my appointment is so far out do you think 10 mg is OK for me to stay on until I see the rheumatologist

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Welcome @issyb, I see that you have already connected with @marmak on your PMR journey. You will notice that we moved your post to an existing discussion on the same topic so that you can read what others have shared on managing PMR symptoms and flares. If you click the link below it will take you to the start of the discussion where you can learn what others have shared.

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

It's good that the prednisone is handling the pain. The morning stiffness was pretty normal for me when I first got up and got better as I moved around some. Then my morning dose of prednisone kicked in to get me through the day. I started at 20 mg prednisone for both of my PMR occurrences. The first time it took me 3-1/2 years to taper off. The second time it only took a 1-1/2 years before I could get off of prednisone. I think I did better the second time around because I made some lifestyle changes - more exercise and healthier eating.

I would not be in a hurry to taper down especially since your appointment is only a little over a month away. Did your GP provide any instructions for the prednisone?

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Thank you so much for your response. Being newly diagnosed this is information is extremely helpful.
I am doing ok on 10 mg prednisone and will take your advice (I agree) and stay on this dosage until I see the rheumatologist.
My GP did not give me any instructions while on prednisone, although I did my own research.
I have changed my diet drastically and eliminated all sugar and any other processed foods. My diet was pretty clean before but I stepped it up a notch !
Again thank you so much
These responses are so appreciated and comforting as well.

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@bradninchgirl

So many of your experiences are like what I am going through right now. I had to go back to 3mg and soon I will have to try and reduce to 2 1/2. I am apprehensive as I really don't want to feel anymore pain. I also have to find an osteoporosis treatment that also does not generate pain, not an easy one. I try and not get discouraged but it's hard when the worst illness I have had in the past was over on a couple of weeks. I have gathered some great help from realizing my Magnesium was of poor quality with only one element in the dose. So I found a better one with three elements and it has helped a great deal. To date, I have found answers and help in this forum every time I go into it. Thank you people.

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Please explain how magnesium is of poor quality. What should be the three molecules / elements be in Magnesium?

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The Magnesium I had not been satisfied with has magnesium oxide 400mg as it's main ingredient. Other ingredients: medium chain triglycerides, gelatin glycerin, rape seed lecithin. I have had no success in shaking the stiff muscle pain over the past year. I felt like my muscles weren't repairing themselves after exercise.

The magnesium I am taking now has magnesium 225mg (with a daily dose of 450mg) magnesium citrate, magnesium glycinate and magnesium malate, zinc, zinc citrate and zinc ascorbate, vitamin D3. Within in one week my muscle pain and stiffness had lessened considerably and my energy and enthusiasm levels improved. I am able to climb stairs in the normal way and can walk upright.

I may be misjudging product 1 and although not listed may contain exactly the same elements as product 2, but after 3 1/2 years I feel so much better after a couple of weeks of taking product 2 and feel like I am ready to start to reduce my prednisone.

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Had gotten down to 2mg and was stable for a few months but pain started to get worse in general, followed by fatigue, then developed GCA and was put on 60mg. Stayed there for a month, then rheumatologist had me drop to 40. That lasted a day; I couldn't walk, was so shakey I sat in a chair all day. He wanted me to stay there for 2 weeks then drop to 20mg. decided to drop by 5mg a week which has worked so far.

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I found that diet and supplements help me a lot. Medication is just one part of recovery in my opinion. I spend a lot of my time reading and searching on line for information on PMR. It helps to do something to occupy your mind and distract from the pain. Not easy I admit but it doesn't hurt to try. I found the British National Health service had a very good online page on PMR. There is light at the end of the tunnel and I hope it opens up for you soon. Don't despair. Recover, at least enough to start enjoying life, is out there.

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Does continuing to exercise help when tapering off prednisone to keep those muscles and joints moving? Drinking adequate amounts of water to be hydrated? Adequate rest? Appropriate diet of anti inflammatory foods?

This disease is just the pits anyway you look at it!

Thanks to all who post on these sights as I think it is a very helpful, supportive activity.

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@mnmom1

Does continuing to exercise help when tapering off prednisone to keep those muscles and joints moving? Drinking adequate amounts of water to be hydrated? Adequate rest? Appropriate diet of anti inflammatory foods?

This disease is just the pits anyway you look at it!

Thanks to all who post on these sights as I think it is a very helpful, supportive activity.

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A big yes to continuing with exercise when you have PMR! My second time around I started eating better and exercising a little more which I think helped me taper off sooner than the first time with PMR - 1 and half years vs 3 and half years. Here's some information that might be helpful that also mentions exercise:
— Can Diet Affect Symptoms of Polymyalgia Rheumatica?:
https://www.healthline.com/health/polymyalgia-rheumatica-diet

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@johnbishop

A big yes to continuing with exercise when you have PMR! My second time around I started eating better and exercising a little more which I think helped me taper off sooner than the first time with PMR - 1 and half years vs 3 and half years. Here's some information that might be helpful that also mentions exercise:
— Can Diet Affect Symptoms of Polymyalgia Rheumatica?:
https://www.healthline.com/health/polymyalgia-rheumatica-diet

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Thank you!

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