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PMR Taper and pain

Polymyalgia Rheumatica (PMR) | Last Active: May 30 12:19pm | Replies (63)

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@lowell77

Hi Gang! Tapering from 25 mgs of predisone about five months ago down to 10 now for my PMR. But lately feeling some slight return of symptoms -- some morning stiffness and slight aches in wrists and shoulders. Overall discomfort is tolerable at this point. Not wincing in pain too much. So I am inclined to tough it out and keep tapering with a goal to get off it in ten months.
My question: How bad must it get before you up your predisone dose a notch?

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Replies to "Hi Gang! Tapering from 25 mgs of predisone about five months ago down to 10 now..."

Hi @lowell77, That's a great question and I think it really depends on the individual and what is considered acceptable pain/stiffness. You might want to check out another discussion here:
--- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/

I always kept a daily log with my level of pain when I woke up in the morning and my dosage scheduled for the day. If my pain was greater than a 2 on my 0 to 10 pain scale, I didn't taper to the next lower dose and if it was really bad I increase my dose by half of the previous taper down so I wouldn't be going back to the previous dose. I would stay at the dose for a week or so before trying to taper again.

Do you keep a daily log of symptoms and dose?

Hi lowell77,

Just giving my opinion from personal experience. I always first look at what I've been doing over the past 3-4 days. Is there something that I've done that could have caused the stiffness and aches in the wrists/shoulders? One time I was ready to increase my dose until I remembered about helping load and unload some furniture from a pickup truck. I did minimal lifting but it was awkward. I gave myself a couple more days and sure enough, the symptoms were gone. Personally, if I can't find something that I've done that's causing the pain and aches, then I'm looking at increasing my dose to the previous level that was effective. Sometimes a dose might be just a hair low to be effective but it takes a couple weeks for the inflammation to accumulate and make itself known through the pain and discomfort. I don't like to give the pain a head start - I try to catch it early so I don't have to go to a much higher dose so it'll get under control again.