Tylenol is not an anti-inflammatory medication. It is widely used for treatment of mild pain and fever. PMR usually doesn't respond to Tylenol because it doesn't reduce the inflammation.

Prednisone is a potent anti-inflammatory medication and should be reducing your ESR much more than it is. Ideally, when a person has PMR, their ESR would be in the normal range if they take enough prednisone. Your prednisone dose might not be high enough but your doctor needs to determine why your ESR is high.

An infection can cause a high ESR and you wouldn't want to take prednisone if you have an infection. Prednisone suppresses your immune system and makes it harder to fight an infection.