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Can sed rate and c reactive results be normal while taking Prednisone?
My rheumatologist is questioning whether I have PMR or something else because after 3 months on 20 mg of Prednisone both my sed rate and c reactive results are normal. He tapered me from 15 mg to 5 mg in 20 days (I was crying in pain) testing every 5 days, but my sed rate and c reactive results showed normal in every test. Could I have something other than PMR? My whole body hurts, but as the day progresses my legs feel like they have elephantitis (but they're not swollen). The Dr has run tons of other tests, we can't figure this out. I'm 75 and really fit, still trying to work out regularly. I don't like Prednisone!
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I'm sorry to hear about all the pain you've been having. I'm all too familiar with too many different tyes of pain over many years, but this PMR pain has been very close to burning searing nerve pain.
It does sound like the taper was way too extreme in dose reduction and time in between each, and I'mjust a newbie (7/31/26 diagnosis).
As for a definitive test for PMR, I was immediately sent for an Ultrasound of my shoulders to confirm my Rheumatologist's diagnosis of PMR. The Ultrasound confirmed the PMR by what showed up in my shoulders, and she also checked my head for GCA, which can often be present for people with PMR.
Thankfully, I didn't have GCA, but do have PMR.
My CRP and ESR were both elevated prior to Prednisone but both have come back into normal range after 2 weeks on Prednisone, but I still experience some pain on one side (which is probably other old injuries etc). So, you might want to ask for the type of Ultrasound that can see in the shoulder. It's a specific type of Ultrasound called "Power Doppler" or "Color Doppler Ultrasound". It can see blood flow (hyperemia) to confirm inflammation and PMR activity. It can also assess and help predict relapse risk. You would need to ask for that specific type of Ultrasound. I'm not sure if every technician that operates regular Ultrasound knows how to use the Doppler type. It's definitely worth asking your Dr. For a referral and to find out if you definately have PMR, and also if you have GCA (Giant Cell Arteritis), which is a whole other horrible disease that can cause blindness and can be fatal if left untreated. This is not to scare anyone but to inform in case someone doesn't know. I never heard of it or PMR until I got diagnosed and had the Doppler Ultrasound. GCA is highly treatable also. Finding out via this type is the first step.
It might be harder to get this type of Ultrasound depending on where you live and what type of Healthcare is available. Insurance should pay for it but you might want to find out ahead of time.
So, CRP and ESR might come back down to normal with Prednisone (it makes sense to me), but that doesn't mean you don't have PMR. If your Dr. isn't a Rheumatologist, it might be good to see one. They're more knowledgeable about PMR, GCA etc than most general Dr's (in my experience anyway).
I hope this helps anyone. Blessings.