Flareups?

A flare up is simply an increase in your symptoms or new symptoms starting up, such as:

Increased muscle pain and stiffness, particularly in the shoulders, hips, and neck
Fatigue
Fever
Loss of appetite
Joint swelling
Headache
Joint pain

It is difficult to know with absolute certainty what constitutes a PMR diagnosis.

It is nearly impossible to know what constitutes a flare. It can be a plethora of things that seem like a flare:
Prednisone withdrawal
Adrenal insufficiency
Osteoarthritis
Myopathy from long term Prednisone use
https://www.ncbi.nlm.nih.gov/books/NBK557731/#:~:text=Etiology,associated%20with%20more%20acute%20presentations.
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The above is only a partial list of things that can happen when we try to wean ourselves off prednisone. It isn't easy to taper off Prednisone no matter how slowly you taper. It is way to easy to increase the prednsione dose and call it a flare.

I think it was only luck that I tapered off Prednisone after 12 years with countless "flares" or otherwise known as relapsing PMR.

I wonder the same thing. I was doing great and tapered completely off prednisone 2 weeks ago. Now seeing increasing stiffness all over and some familiar old PMR pain in certain places. Every day and every hour of the day is different. It has me spooked! PMR is such a weird condition.

@dadcue
I agree with you about determining what constitutes a flare.
I was tapering and holding at 7mg for weeks but could definitely see I had adrenal suppression symptoms. I’m positive I have myopathy from being on fairly high doses of prednisone for over 2 years.
I just got a blood test back showing my high inflammation has returned.
I’m so discouraged to increase dosage to 15 as my rheumatologist suggests and start to taper again.
I’m thinking of just going to 10 at first.

@elsbeth
Try 2 Tylenol for Arthritis as a bandaid….works for me

I am coming off Predisoine after 8 months down to 1mg. Every other day.
So far so good BUT I started some exercises and notice mild flare ups. Not sure if my muscles are sensitive , due to PMR or if i am stressing out my immune system. plan to talk with my Rheu.doc soon....i am 77 yrs. young... Active guy.

Just a reminder, if you have adrenal insufficiency from long term steroid use of over the equivalence of 2.5 mg/day of prednisone, you will need to increase your dose (with a doctors care) for any increases in physical stress, infection in particular. Sometimes even just the common cold

@laura1970

For permanent or "absolute adrenal insufficiency" with no hope of ever getting off prednisone you need to "anticipate" and "predict" stress before it happens so as to increase your prednisone dose accordingly. Absolute adrenal insufficiency from long term Prednisone use is somewhat rare for PMR/GCA patients and depends upon dose and duration of Prednisone use.
https://www.the-rheumatologist.org/article/study-probes-corticosteroid-dependence-in-polymyalgia-rheumatica/
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There is something called "relative adrenal insufficiency" which is more commonly caused by long term Prednisone use. Long-term use of prednisone can cause relative adrenal insufficiency, also known as glucocorticoid-induced adrenal insufficiency (GI-AI), by suppressing the body's natural ability to produce its own cortisol. This condition usually isn't permanent.

When an endocrinologist was counseling me about a relatively low cortisol level after 12 years on Prednisone she was surprised that I still had some adrenal function. She said I needed to preserve whatever adrenal function I had left. She said to increase my dose only "if absolutely necessary" but otherwise I should not increase my dose. Ideally, I should call her first before increasing my dose but she didn't insist that I call her first.

The Prednisone Pharmacist recently made a video about this topic:

@dadcue I absolutely agree with all you said, also remember if possible to take steroids as early in the morning as possible (5 am is ideal but often unrealistic) as this most mimics intrinsic adrenal function

I once saw a patient (not with PMR) who had taken moderate doses of steroids for years. She had just gotten out of the hospital (a large well respected university hospital) where she had spent a month and a half in the ICU and 2 weeks on the floor. She came in with many complaints, the most urgent in her view was over the top fatigue.

In reviewing her hospital records, she hadn’t gotten stress dose steroids the entire admission! It’s important that you as well as your loved ones know of the importance of stress dose steroids so you (or your loved ones if you are incapacitated) can best advocate for yourself