It is incredible to me how good my shoulders and arms are in spite of all the severe pain in that part of my body when I was diagnosed with PMR.

My mid section down can only be described as a disaster zone. That part of my body wasn't so good before PMR was diagnosed.

I had a very long 12 year history of PMR. My original presenting systems of PMR were almost entirely my neck, shoulders and arms. I was begging for prednisone because of an even longer history of inflammatory arthritis which seemed to attack my spine and knees the most. Inflammatory arthritis was associated with uveitis which attacked my left eye mostly. I lived in fear of a day when I wouldn't have access to prednisone and that day arrived in the form of PMR. The pain had a way of spreading everywhere.

I have never heard of prednisone being described as "cartoonishly effective" but that was how it worked for me. One dose was sometimes all it took and I was "cured" of inflammatory arthritis. I usually took about 40 mg more or less for inflammtory arthritis. Fortunately a wise rheumatologist could discern that something different was happening that suggested PMR instead of inflammatory arthritis. When PMR was diagnosed, I got to take less prednisone but on a long term basis.

There really wasn't that much difference in the pain I felt with inflammatory arthritis as compared with PMR. The main difference was inflammatory arthritis was acute onset like overnight whereas PMR and PMR flares were more gradual over a few weeks and continued to get worse unless I took more prednisone. I was also "old enough" to have PMR whereas I was much younger when inflammatory arthritis started.

How long PMR and the need for prednisone lasts is anyone's guess. There are better treatments than prednisone for inflammatory arthritis. My understanding is that prednisone doesn't prevent the damage caused by inflammatory arthritis. I took prednisone for PMR for a very long time. Now I seem to have an inordinate amount of arthritis in my spine, knees and pretty much from the waist down.

I challenged my rheumatologist on more than one occasion about whether I still needed prednisone for PMR. She reassured me that my primary diagnoses was PMR but I still had inflammatory arthritis.

I'm off prednisone now thanks to a biologic targeted at PMR. The biologic was originally developed for rheumatoid arthritis but that isn't the type of inflammatory arthritis that I have. The hope was that the biologic would help both PMR and inflammatory arthritis. It is quite possible and more likely to have more than one autoimmune condition. Unfortunately when prednisone is used to treat PMR, arthritis can still occur and get worse.

The moral of this story is that prednisone taken by PMR sufferers doesn't prevent arthritis from becoming worse.