Morning misery: Is prednisone effective 24 hrs? PMR and hands

No, the 2mg evening dose with a meal at 6.30pm doesn't affect my sleep. I do wake twice each night, but I've been doing that for years, so no change there. I used to take the small dose earlier at 4.30pm and there was no morning pain taking it at that time either, but I sometimes forgot to take it on time at that busier time of day. Mealtime is easier to remember for me.

I also take a small dose (1mg) of melatonin at 9.30pm, and that probably helps me get straight back to sleep after waking. I'm on a beta blocker (heart issues) which stops the production of melatonin, so it's to compensate for that. My doctor prescribes the melatonin and suggested I take the lowest dose. Melatonin has an anti-inflammatory effect, but taking more than a low dose can interfere with the effectiveness of prednisone.

This is a really good question about adrenal insufficiency, I’ve never asked my doc about that.

It began 3 days after my fourth covid shot. I suspect I already had it and the vaccine caused a flair.
I have begun weaning from 16 mg of methylprednisolone to 8 mg. Two weeks ago I added a weekly Creator for inflammation(not prescribed). Three days ago I added Curcumin 500 with Bioperine. The only grain I consume is 6 tablespoons of oatmeal daily. Other than that I have no changes in diet. I do milk exercises both day and at night when I wake up. In addition to inflammatory markers I am going to use the exercises for diagnostic purposes. I have no pain or soreness when at rest.

I was diagnosed with PMR in June 2022 and started on 20 mg of pred. I have decreased slowly but my doc wants m e to get off ASAP. From 3 mg down I have had a lot of pain, I'm down to 1 mg/day now and after a miserable Thanksgiving, finally had to contact my doc for some help. He said my last ESR was in the normal range so I probably don't have PMR. I wish he could sit with my pain for a day because I have all the symptoms. Does anyone have any ideas about what other conditions could mimic PMR symptoms. I'm feeling very frustrated and I feel like the doc thinks I'm a hypochondriac

I got very frustrated with morning stiffness and waiting for a morning dose of prednisone to take effect sometime after 12 PM.
I found the article on nighttime doses of prednisone.
It has made a huge difference for me. I set my alarm for 2 AM and take my prednisone. When I get up at 7 AM I am almost free of PMR stiffness.

You need a different doctor that understands PMR, will prescribe enough Pred that you can adjust according to pain and stiffness while always trying to decrease without the pain coming back.

Thanks, that's what my kids are saying also but I'm always so afraid of offending
my doc, but you have given me confidence to stand up for myself.

@linneyshop I had similar problem and my doctor sent me to a rheumatologist who said it was RA which requires different meds. I am trying to get off prednisone and it seems to have helped.

Have you tried Volterin in the morning? When I came off prednisone for 5 weeks in August, I had a 5 day flare that put me right back on prednisone. My hands were so stiff that I could not press the button on a can of shaving cream. The Volterin did the trick until the prednisone kicked in again.
Good luck

In October, 2022 when I was diagnosed with PMR in the hospital ER, both hands were so swollen & painful I couldn’t even dress myself. The thing that usually distinguishes PMR pain is it is usually bi-lateral. (both hands, shoulders, etc.) I also have osteoarthritis. That pain is limited to one area at a time. Not to be confused with pain from PMR. And not really affected much by Prednisone. Hope this helps.
Wishing success in your treatment.