There are plenty of alternatives to taking prednisone for PMR. The trick is finding something that actually works. I have tried methotrexate and leflunomide along with a variety of NSAIDS. However, you shouldn't really take NSAIDs and prednisone together. Some people get by with just an NSAID which some rheumatologists might say is preferable to prednisone. For me, the NSAIDs didn't help me very much.

From what I read, LDN and hydroxychloroquine works for some people. I don't have any experience with those medications.

You need to be aware that it may not be just PMR you are dealing with. It may be a combination of things or something else entirely. If it is inflammatory arthritis, maybe a TNF inhibitor like Humira might help. Humira wasn't particularly helpful for me.

I would say methotrexate worked but I wasn't able to taper off prednisone. I did get to a much lower dose of prednisone after about a year of methotrexate. By that time my liver enzymes were increasing and I didn't like retching every morning. My rheumatologist wanted me to keep taking methotrexate but I stopped it.

Leflunomide worked. I got off prednisone for a couple of days. Leflunomide stays in your system for months. Infections were a problem the whole time I was taking leflunomide along with prednisone. I got an infection on the day I stopped prednisone. I think my body was deficient of cortisol and didn't like not getting any prednisone that day. Let's just say I had a "pain crisis" and needed 60 mg of prednisone again. My rheumatologist told me to stop leflunomide because of infections caused by "too much immunosuppression." The emergency room doctors wanted me to take prednisone because of a low cortisol level.

The only thing that has worked for me as evidenced by being able to taper off prednisone completely was a biologic called Actemra (tocilizumab). It isn't FDA approved for PMR but it is approved for GCA. If you have RA then Actemra is approved for that too. My rheumatologist need to seek authorization to get Actemra approved for me. I still take Actemra for PMR. I guess that I still have PMR so I'm not cured but I don't have very much pain anymore.

I don't have RA but I have another kind of inflammatory arthritis along with uveitis. My ophtalmologist said Actemra is "not optimal treatment" for uveitis. Now my ophthalmologist says Actemra "seems to be working" for me. Your mileage may vary.