77 year old male with PMR

Do you know what size the pills are? I assume they're 5 mg. That's a pretty typical starting dose for PMR, but it can range from 12.5 mg to 25 mg or higher. How long have you been taking the prednisone? You should be feeling quite a bit better within a week of starting. If you don't feel better, you probably need a higher dose.

Most likely you will need to keep taking prednisone for at least one to two years, but it could be longer. Prednisone has a lot of side effects, so your doctor will need to monitor for those. It can cause thinning of bones, eye problems (glaucoma and cataracts), higher cholesterol, higher blood sugar, weight gain, and other problems.

Because of the side effects from prednisone, your doctor might want to start you on another drug that reduces the need for prednisone. Those drugs are methotrexate and Kevzara. They also have side effects, but the side effects are usually not as bad as the ones from prednisone.

People on this forum can advise you on how to deal with any side effects that you encounter. Good luck with your treatment!

Thank you for your support. I'll talk to my Doctor tomorrow and see where we go from here. I'm feeling much better than when this first started about 3 weeks ago, but still in major pain, mainly in the mornings. I'm taking 3 tabs of 5mg Prednisone a day and today is my 10th day. Still unbearable pain in neck, shoulders, and butt and hips. You're right about my blood sugar, it's super high and I'm a diabetic. When will I get better and this go away?

It does sound like your dose of prednisone is too low since you're still having a lot of pain. I have GCA and PMR, and I felt better immediately when I started taking prednisone. But I was on a high dose - 60 mg per day. You might need to be on 25 or 30 for a few weeks to get your inflammation under control. If you get on the right dose, you shouldn't have any pain.

Regarding your blood sugar, I'm not an expert in that area. I know that a lot of people who take prednisone cut back a lot on carbs, but you're probably already doing that. You'll need to work with your doctor or endocrinologist to deal with prednisone's effect on your diabetes.

As to when the PMR will go away, that's hard to say, because everyone is different. The standard answer is 1 - 2 years, but for some people it can last a lot longer than that, as much as 15 years or more. It can also go away, and then come back as a flare. It can also flare if you taper the prednisone too fast, so you have to be careful tapering. There are a lot of discussions on this forum about the best way to taper prednisone.

Since 10 - 20 percent of people who develop PMR also develop GCA, you should be familiar with the symptoms of GCA, just in case. GCA can cause headaches, night sweats, vision problems, tenderness on the scalp, and tired jaw muscles when you're chewing food. If you ever have unusual vision problems, like sudden loss or blurring of vision in one eye, go to the emergency room. If you have any of those other symptoms, let you doctor know.

When I was diagnosed with PMR/GCA in July 2024, I started with 60 mg. of prednisone for 6 weeks and then started my taper. I never had blood sugar issues until I started taking prednisone. I started daily glucose monitoring. Not unusual to have over 200 bs. One afternoon, it was 387. My primary put me on metformin. BS has improved and I'm down to 4 mg. of pred. Will start 3 mg. next week for a month.

PMR affects everyone differently. I think @jeff97 summarized it well. I continued to have neck, shoulder and wrist pain until July 2025. It wasn't bad, but it was there. I have been able to resume my activities (golf and pickleball). I have been on Actemra infusions since Jan. 2025. The Actemra has allowed me to taper, without any flares.

This is a good forum. If you have any questions, toss them out here. Someone will always give you a response. You can also search the topics. I've learned a lot about PMR and GCA.

If you have previously taken, and/or are still taking Statins, you might want to consider not taking them for about 30 days. I did and all of those debilitating pains disappeared.

As someone said, this is an excellent forum, so continue to use it. I've learned much here.

First, is your doctor a rheumatologist?

Second, prednisone helped my pain immediately. (I'm a 68-year-old female and a runner of 52 years who suddenly could barely walk.) Within 24 hours, I was out of pain. (Like everyone, I had pain in the neck, shoulders, and hip area. Horrific pain. I was back to running 5 miles within the 24 hours of taking one 20mg tablet.) So I'd talk to a rheumatologist who understands PMR about the continued pain.

This is a tough disease, but I hear remission is possible. Hang in there.

It can take some of us longer than others to feel better. My pain was around the knees, shoulders, elbows and hands/wrists, so like you, it was quite disabling. After a week on 15mg of prednisone I felt 70% better, and recall complaining to my doctor that I expected more. It took me a few weeks to feel 95% better. If there's one thing PMR has taught me, it's patience, and keeping as active as possible doing the things we can still do. Improve the diet, drink plenty of water with the prednisone, and keep the body moving.

For me, when my PMR made me a complete cripple who needed help with everything, it took about 4 hours after my first prednisone shot for me to feel a lot better and it took a couple of weeks for the doc to throw me out of his practice, saying I was cured and he did not want to see me again for this problem. And I was indeed cured. His staff got a great laugh when he jokingly threw me out.

I wonder if yr dose is enough? My first shot caused swelling at the injection site and the doc said, « I never did that before. » I believe he meant that he hit a nerve. Not sure of anything. Maybe the shot into the nerve caused the spectacular cure? It was an accident but maybe a fortunate accident?

Yes. Patience. This is key. I know this disease is frustrating at times. When I was diagnosed, I realized that having expectations on my progress was unreasonable. Can't worry about something I have no control over. I've kept this attitude throughout my journey and it's kept me sane.