If I choose to take no meds. What is the worst that can happen?

Not sure if I would go down that road. I waited for 3 months after I started feeling the pain symptoms from the PMR before seeing a rheumatologist. My wife had to take me to the appointment in a wheelchair all because it was toward the end of the year and I wanted the cost on my new insurance policy. Can you discuss other treatment options with your rheumatologist?

The ongoing untreated inflammation of PMR can cause its own problems with tissue and organ damage. Balance the inflammation damage you're likely causing your body by not getting treatment against the side effects of treatment drugs. I struggled with the same dilemma for two months before realising it wasn't going away by itself, and deciding I couldn't go on with the pain and loss of ability to do basic everyday things any more. I later found out about the harms of ongoing inflammation. Not being treated has its own health problems.

I also struggled with taking steroids. I was fairly well educated on the use and damage that they could cause so I was reluctant to start using them. On the other hand, I was in so much pain that I felt like life was almost over. Four hours after my first 20mg of steroid , I was pain free. I quickly moved to 10mg. That was my sweet spot. One of my orthopedic Drs had told me that I need to find the source of inflammation or risked damaging the joints. Damaged joints would then become an arthritis that can stay with you forever. Your doing the right things. Ask questions and google everything you can find on prednisone damage and withdrawal. Dont allow yourself to stay on it. I have always went to the gym. This is a time when your joints need the movement. Make yourself exercise. Watch your diet. lower your sugars and carbs. Try meditation or anything that helps with stress. I have never done Pilates but try a class. Become your own advocate. As much as Dr dont like to be questioned a good one is willing to share in your treatment. Understand what his/her goals are and take notes. Go to the Dr visit with written down notes to ask. I was 70 when I got PMR. It lasted 6 months and I was off steroids. I had no other medical issues so that can complicate your treatment if you have other things. But face it as a challenge. You might try one of the biologics. Actemra is one. Those can take 4-5months to start working. I dont have much information on those. here is a quote from Harvard medical school.
"Chronic inflammation in the joints can damage cartilage, bones, tendons (which attach muscle to bones), or ligaments (which hold joints together); irritate nerves; and produce a long list of symptoms, including pain, swelling, and stiffness. The joint damage may be progressive and irreversible." Good Luck

I couldn’t have said it better. I took prednisone for a year. They were a miracle. Pain and stiffness was relieved and i could function and exercise again. Started on hydroxychloroquine 2 weeks ago to help with the hair loss, stiff muscles, very sore joints caused by inflammation in my body that i just cant get rid of. Achey and stiff with days of lots of pain. Haven’t noticed any side effects yet. Had eyes checked before starting it. It’s helping me get my life back and that’s well worth some side effects that’s are minimal. My rheumatologist told me that hydroxychloroquine is one of the safest options. I find it funny that many of us with PMR say we used to be very active and went to the gym. It really stopped me from doing what i enjoy. Now after 1.5 years with PMR I am 75 and back to 80% of where i started. I give my rheumatologist a shout out. She listens and doesn't just imply that my symptoms are because I’m old which is a standard answer from primary care.

Agree

I can understand not wanting to be on prednisone. Me either! But, reality has a funny way of taking over. At least for me the approach has been multi-fold. I not only am physically active (as much as I can) while I am treating this disease, I am also exploring and implementing all sorts of other (alternative?) approaches. Given that western medicine does not really know the cause and just barely knows the exact mechanisms of this disease, I have taken on chiropractic twice per week and acupuncture once per week. They each have their own "ideas" as to why PMR came on to me. Bin theory, both of those approaches are to calm the central nervous system. In other words to re-train my CNS to be in a rest/digest (parasympathetic) mode and not the flight /flight mode (sympathetic). The acupuncture for me is to replenish my Yin deficiency. An Aryuvedic Dr is helping me nourish my mucosa through my body with various herbs. I even take bone broth every day as a way to "heal" the possible leaky gut (intestinal permeability) which is gaining ground in the western medical field as a possible cause of this and other ailments. On top of this, I am taking prednisone, starting at 15 mg in May (diagnosed in April) and have tapered now to 6 mg per day without pain other than my normal level of aches and stiffness that I always had (I most likely have Ehlers Danlos but have not been formally diagnosed that has informed my physical problems my entire life). My eating habits have always been VERY good. The idea of a low inflammatory diet has been my cornerstone for over 30 years. I grow most of our food. I practice "my" version of meditation and I have been seeing a psychotherapist for decades. Something (all of these things?) seems to be working for me. No miracles or nirvana (not yet!). I say all this to show you that if you want to "get well" you need to find what works for you and pursue any and everything that sits well with you. I do not proport to understand all these different approaches but being sick really sucks and the prospects of being this way forever (?) did not look good. I am not familiar with long term damage from untreated PMR, but there is anecdotal evidence on this site that long term untreated (due to it being undiagnosed) PMR is more entrenched and harder to treat. I have an open (unfilled) prescription for Kevzara if I need it. Who knows but my model of throwing the kitchen sink at my health issues is about all I had as an option. I was almost in a wheel chair after 1 week of this coming on. The prior week to that I was skiing powder in my home state of CO. I am a 63 year old male. Good luck!

Chronic untreated inflammation is a killer, plain and simple. Over time your organ's abilities to manage and eliminate the inflammation will begin to degrade your organs. Also inflammation in the joints can and does cause bone damage. You will see problems all over your body. You really do not want that. My best advise is to get treated with the smallest effective dosages of whatever you and your doctor decide is best for your case. Begin eating an anti-inflammatory diet today - do not feed the beast, it simply does not make sense. Exercise moderately at the level you reap benefits and inflict no damage. Achieve appropriate rest. Focus on you and lifestyle adjustments that help you reach your overall goals, whatever they may be. You have a problem where your mind and your body are not on the same page and it is solely up to you to get them back together. Doctors can help but you are the project manager - i. e. you are accountable for decisions and consequences. Become informed because knowledge is power.