Inflammatory disorders like PMR cause fatigue. When you have chronic pain, you are exhausted at the beginning of the day. Pain along with prednisone makes it hard to sleep and you wake up with more pain. Poor sleep causes an increase in inflammation which makes your pain worse and more fatigue follows. It leads to a downward spiral.

Prednisone should energize you when you first start taking it. Prednisone is a glucocorticoid that mimics the action of the body's natural hormone cortisol. Unfortunately, prednisone shuts off the cortisol that the adrenals should produce.

As you slowly decrease your prednisone dose below 7 mg you are gently trying to persuade your adrenals to start producing cortisol again. Sometimes the adrenals balk at resuming normal cortisol production. "Overwhelming fatigue" is a symptom of a low cortisol level.

Will you ever get off prednisone? Will you ever feel better again? The answer depends on how soon PMR goes into remission. After that, it depends on how quickly your adrenals are able to produce enough cortisol so that you can taper off prednisone. It is a two-stage process that can take a couple of years.

In my case, it took me many years. Yes, I do feel much better being off prednisone. I wasn't able to get off prednisone until a biologic was used instead of prednisone to control my symptoms.

Just keep telling yourself YES, things will get better again. Saying NO means you have lost hope and that doesn't do you any good at all.