Have you tried spitting your dose. For many people, pain relief from prednisone doesn't last an entire 24 hours. When I took my entire dose at 8 a.m. the effects of prednisone would wear off in the middle of the night. I would routinely wake up with pain and stiffness at approximately 4 a.m. at which time I took my entire morning dose of prednisone. At 4 a.m. I was faced with a decision to call my employer to say I was unable to work. If I took prednisone at 4 a.m I was able to go to work at 7 a.m. even though work would seem impossible at 4 a.m.

My sleep cycle suffered when I woke up in pain at 4 a.m. because I was unable to go back to sleep because of pain. Prednisone works quickly but not immediately. When I started to split my prednisone dose 2/3 in the morning at 8 a.m. and the remaining 1/3 in the evening before bedtime, I miraculously slept the whole night and didn't wake up with the pain and stiffness.

The added benefit was I could take less prednisone over the 24 hour period. I didn't seem to need a big 50 mg dose of prednisone first thing when I woke up. I managed well with 20 mg in the morning and 10 mg in the evening reasonably well.

I tried to explain this concept to a doctor once. They were of the belief that I should take my entire prednisone dose in the morning. This doctor said whatever I was doing ... keep doing it because it seemed to work for me. Consult your doctor to get their opinion. Some doctors aren't as open-minded as mine was.