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How to address PMR pain while decreasing prednisone
Polymyalgia Rheumatica (PMR) | Last Active: Nov 6, 2023 | Replies (747)Comment receiving replies
Hello all PMR sufferers. I was diagnosed 6 months ago and was put on 15 ml. of prednisone per day for 6 weeks. Went to 10 ml. per day for 2 weeks and now I'm down to 5 ml. per day and experiencing some pain coming back in my left shoulder . I do not want to take more of the prednisone for the shoulder pain and was wondering if a cortisone injection at this time would be a better choice and keep taking the 5 ml of prednisone daily. I have found that taking my prednisone at 2 am works so much better for me as I am not stiff and sore as much when I get up in the morning. It does not effect my sleep as I have read that it can if taken at night.
Replies to "Hello all PMR sufferers. I was diagnosed 6 months ago and was put on 15 ml...."
I can’t tell the difference between PMR pain and arthritis pain, except that PMR was all consuming! I have tapered down to two mg of methylprednisolone from 16, in six months. No pain in the morning, but after two or three pm I’m a mess!
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Welcome @limbmaker, It sounds like you could be tapering a little too much too fast. When it comes to PMR, no one likes to take prednisone but it is the magic bullet if you have PMR. It is normal to wake up with some aches and pains in the morning when you have PMR and the mornings dose should get rid of it within an hour or so if it is PMR. Here are a couple of reference articles that provide more information:
--- Treat-to-target recommendations in giant cell arteritis and polymyalgia rheumatica: https://ard.bmj.com/content/early/2023/02/23/ard-2022-223429
--- 2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative:
https://ard.bmj.com/content/74/10/1799
I've had PMR twice, both times I started at 20 mg prednisone. The first time it took me 3-1/2 years to taper off, the second time took me 1-1/2 years to taper off. My second time around was easier due to my changing my lifestyle by eating healthier, less inflammatory foods and sugar and exercising more. My rheumatologist also suggested I keep a daily log with my level of pain when I woke up and my dose of prednisone for the day which I think helped a lot to determine when the correct time and amount was to taper down. There is another discussion you also might find helpful:
--- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/
Do you keep a daily log?