cliffg26 Not sure what you mean by serious case - but you need to consider trying classic treatment of prednisone. The first Rheumy I saw wanted me on 40mg per day to start, I went thumbs down, the next one was at 20mg for starters. I stuck with her but we treated me with steroid injections in major pain points for a while. I also was on 3,000mg Tylenol per day to keep the pain at a tolerable level. Then I had Covid and my inflammatory numbers shot way way up again. This time I started on 5mg, went to 10mg and am now down to 4mg. Just know that coming down is slow and steady wins the race. My PCP was even willing to start me at 1mg and go up till pain was gone. I was and still am very reluctant to take prednisone.