Hi there- Congrats on getting to 10 mg prednisone. But it can be disappointing to have a flare—between the pain and the uncertainty of it, it’s tough.

It sounds like you’re having a similar experience to my father. He also had to go up to 30 mg. For what it’s worth, it seems common when trying to get to 10 mg and below for things to get a little sticky.

To answer your question, it can be hard to know. It could be a “mini flare,” as you say—it might pass in a few days because other things could affect inflammation. If your pain increase is minimal and you’re comfortable waiting it out at least two to three days to see if you get back to baseline, that seems reasonable.

But my PT’s guidelines are that if my pain level goes up by 2-3 points and remains elevated for 2 or more days, it’s probably time to intervene.

Even without that guideline, if you get to be in a lot of pain and much more limited, usually it’s better to do a slight increase in prednisone, and then try again. It’s frustrating, but your body just might not be ready. For my family (father has PMR; I’m a caregiver), we decided it’s not worth giving up the quality of life and risking a potentially larger and more prolonged flare. But a lot of that depends on what you feel comfortable with and what you and your doctor decide. Glad you can check in with your rheumatologist, and hope you feel better soon!