Hi @redboat, I think the answer to your question may be different depending on who you ask. I I think that's because each of us have different pain tolerances on a scale of 0 to 10, my 2 level may be a 0 for some and maybe 3 or 4 for others. I also started at 20 mg/day prednisone for both my occurrences of PMR but others have started at 15, 30, 40 or something else depending on their symptoms and pain.

You mentioned still experiencing significant pain in the morning. I assume that is before you take the prednisone dose for the day. I always had a little pain in the mornings after work but I would classify it more like an ache on a scale of 1 or 2 max and it usually went away when I got up and started moving around some and was all gone shortly after my morning dose of prednisone.

Is any of the pain you experience in the jaw, scalp or temple areas? These types of pain can indicate a more serious condition of GCA which can accompany PMR and is normally treated with a higher dose of prednisone.

Hi, I'm down to 10 mg since starting 20mg in December. It's like 12hours of pain and then 12 hours of no pain. Like you, at first it was constant. Next week I'll try to go down to 5mg. I'll let you know.

Just my opinion but I feel that pain should be gone or nearly gone before starting to taper your prednisone dose. When you were first diagnosed you had a mountain of inflammation built up and typically it takes 15 to 20 mg to bring that inflammation under control, resulting in minimal or no pain. When I initially was put on pred I started at 15 mg and it was a miracle with the pain vanishing. However, my rheumy wanted me on an aggressive reduction schedule and within a month or 2 I had a massive flare up from taking too little pred. That time I had to move all the way up to 30 mg before the inflammation was knocked down and my pain was brought under control. Reduction should be a very slow path. If you suffer significant pain it means you're low on the prednisone dose. The one rule I learned early on is that the dose reduction should never be more than 10%. A bigger reduction invites a flare and after each flare you end up having to go to a much higher dose to get the inflammation under control again. Some rheumies (in my opinion) are hellbent to get a PMR sufferer off of pred too quickly. Yes, some of the side effect do suck but without pred I would have been an invalid. Do I miss what I used to be? You bet, but I've gained great appreciation that I can control this beast inside me and live a normal life - at a reduced level. PMR forum discussions are a very important source of information and support.