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Diagnosed with PMR 16 days ago.
After weeks of struggle, I was diagnosed with PMR on 17 June 2025, 16 days ago. The emergency doctor prescribed 20 mg of prednisone and he gave me two weeks worth. The first week it seemed to work well I started the day in a little bit of pain, but by mid morning 10-11 AM, I started to feel good After the first week however, it took longer and longer into the day before I would get any relief sometimes 3 to 4 in the afternoon. I had to call my primary care physician as a result, and after some discussion and hesitancy on his part, we upped the dose to 30 mg as of this past Saturday The first two days I felt like given that the dose had been raised, I was surprised to not get as much relief as I was expecting. But starting late Monday and then come Tuesday and Wednesday I was actually doing quite well. I would wake up a little sore and there was no decline from the time I took the medication to the point where it would then kick in so I was feeling rather optimistic. That was until last evening, 2 July, and into today. I started feeling much stiffer than I would’ve expected for the time of day and by the time I had gotten up in the morning, I was so stiff that I was back to a debilitated state. Not sure what to make of this. I would’ve thought that the 30 mg would’ve would’ve continued working like they had the two previous days but for some reason, I’ve just had a big setback. I do have a doctors appointment today but I do not know what’s gonna come of that appointment cause my doctor is very hesitant to play around with prednisone. Any suggestions would be helpful thank you.
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The labs should be repeated. Sed rate and CRP with
an autoimmune battery if not already checked.
Have your PCP get you in with a rheumatologist soon.
Know your results and plan to be proactive about side effects with prednisone.
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5 ReactionsI agree with @seniormed that you should see a rheumatologist as soon as possible. But it could be that your pain and stiffness will improve in another few days. Here is a quote from Google:
"Inadequate response: If symptoms don't improve adequately within 7 to 10 days, the diagnosis of PMR may need to be reconsidered, or a higher prednisone dose might be necessary." Considering the clock started for you this past Saturday, at 30 mg, maybe you'll start feeling better soon.
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3 ReactionsIt sounds like your pain and stiffness is worse in the morning. Maybe you can try splitting your 30 mg dose so that you take 20 mg in the morning and 10 mg in the evening. That might be "playing" with prednisone but many people have "better all day pain relief" when they split their dose. Ask your doctor to see what they think. Otherwise, try it for a couple of days to see if that works for you.
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4 ReactionsJust got back from my doctor ( 3 July) Going for blood work tomorrow morning before my next prednisone 30 mg dose. Depending on how this next 2 weeks goes I suspect my doctor will do the referral. He kind of mentioned it today. Thanks.
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1 ReactionHere’s to hoping you are right. Cheers!
@dadcue, Depending on how the next few days go, a phone call to discuss this will be happening. Thanks for the suggestion.
Started on 40 mg and then went down to -0- within two months. I do take an occasional Tylenol but feeling good. Eat extra healthy, no alcohol, light exercise when possible, reduce stress as much as possible and get out and soak up some vitamin D. STAY POSITIVE! GL
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2 ReactionsA slow taper isn't necessary for all conditions. I could do 60 mg to -0- within a month or two for some other autoimmune conditions. I couldn't taper that quickly after I was diagnosed with PMR. It was probably a combination of many things but it took me 12 years to taper off Prednisone after PMR was diagnosed.
Eventually, I was able to taper off Prednisone. After Actemra was started for PMR, I was able to taper off Prednisone again going from 10 mg to -0- in a year. Then I had a flare of one of my other autoimmune conditions and I needed 60 mg again. Fortunately the other condition was the one I could go from 60 mg to -0- in a month or two to put it back into remission.
I needed to work around the problem with adrenal insufficiency. After almost 30 years, I'm so happy and grateful to be completely off Prednisone for almost all of the past 5 years.
I love your advice ... especially the last part.
"Eat extra healthy, no alcohol, light exercise when possible, reduce stress as much as possible and get out and soak up some vitamin D. STAY POSITIVE!"
I like soaking up my vitamin D again too. My skin was too thin when I was on Prednisone. I only do a monthly infusion of Actemra now. My rheumatologist says she will prescribe something else for pain if I need it but I don't even need tylenol.
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2 ReactionsSee a rheumatologist. Most MDs don't have a good grasp on PMR.
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1 ReactionI must be very fortunate. My GP whom I saw last week for my yearly Wellness Visit actually gave me as much if not more info as my rheumatologist regarding tapering prednisone and basic general info regarding the condition. Granted I have personal relationship with GP and am comfortable messaging him through the Care provider system he belongs to. Rheumatologist is very attentive and answers questions quickly but (maybe I am a lucky one) my GP is knowledgeable regarding PMR. With this condition I do believe use EVERY available resource to understand, treat and then get off the meds as we can.
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