Morning misery: Is prednisone effective 24 hrs? PMR and hands

Posted by fjn @fjn, Apr 16, 2022

Is prednisone meant to be effective 24 hrs? Every morning I can barely move, it takes 3 to 4 hours before the prednisone kicks in. Is this everyone else’s experience? My hands are the worse but my doctor says PMR doesn’t affect your hands. Anyone else have hand problems?

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Good morning,
Is all I can speak on is my own experience. But this PMR affected all my joints and my hands and feet had swelling. It became a chore to dress myself and radiating pain and I believe when the pain is in both arms, feet, shoulders at the same time. Something is wrong in the bodies control center. I don't want to speculate your situation, I truly believe our bodies react differently. (So what your is your and in this case mine is my own.)
Kinda sounds like a prenuptial lol.
My pain, swelling swelling, discomfort for the most part is gone the entire 24 hours. That said prednisone can make you feel weird at times, hard to explain. Like a heighten awareness maybe finding stuff or things annoying.
But from all the info in all these communications dosage is important.
I say you have to trust those professionals, or attempt a second opinion.
Further look around and it's my belief that Covid and the following vaccinations are something we many have in common. Beside our pain and PMR.

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My experience has been that the appropriate dose has kept me pain-free for 24/7. I started on 20 five weeks ago. After 4 days, still in a lot of pain, so doc bumped me up to 30. No more pain, ever. After 2 weeks, tapered to 25. No pain. After two more weeks, tapered to 20. Still no pain. The key to no pain seems to be availability of your dosage doc to review and adjust dose timely as might be needed, and not based on some arbitrary appointment date (e.g., 4 weeks) in the future.

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@art43

My experience has been that the appropriate dose has kept me pain-free for 24/7. I started on 20 five weeks ago. After 4 days, still in a lot of pain, so doc bumped me up to 30. No more pain, ever. After 2 weeks, tapered to 25. No pain. After two more weeks, tapered to 20. Still no pain. The key to no pain seems to be availability of your dosage doc to review and adjust dose timely as might be needed, and not based on some arbitrary appointment date (e.g., 4 weeks) in the future.

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I totally agree that we need our doctor available to review medication dose and symptoms in a timely way. My newly qualified doctor suggested a rheumatologist referral, saying she may not have enough experience to manage PMR, but the nearest rheumatologist is over an hour's drive away and appointments are too far apart, when it suits them, not me.

So I stayed with her because she's available and flexible in her treatment. We have monthly appointments to review the previous month and work out the following month's plan together, with me contributing ideas and experiences from this forum. (Thank you everyone here!)

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@seniormed

Thinking about our various symptoms with a diagnosis
of Polymyagia we should consider other possible causes
as well. Prednisone will alleviate pain and inflammation
regardless of any neat diagnostic category.
If a senior also has another form of arthritis it is likely to
respond for a time to prednisone as well. Prednisone
therapy could mask another coexisting condition and
delay diagnosis. We need to keep an open perspective
along with our physicians.
Very classical PMR responding nicely to tapering prednisone eventually allowed bilateral carpal tunnel
to become apparent for me. Eventually responding
wonderfully to Humira with psoriatic arthritis after two years. With minimal symptoms left they well could be just osteoarthritis at my age. Inflammation is the thread common to all rheumatic conditions.
Stay informed and consider that a good doctor should
welcome a second opinion and consider the possibilities.

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We are all different, and since prednisone relieves any inflammation, yes, it may be another form of arthritis. But it can be PMR affecting hands. I broke my right wrist in Jan so have X-rays that show very little bony arthritic change in my hands… totally expected in any 64 year old. However my hands are bilaterally painful in the morning, with mild swelling between the knuckles and no pain to palpation of the joints. My rheumatologist agreed it was part of my PMR presentation. And it is interesting, good days have minimal shoulder/ hand pain. Bad days affect both. This is round 2 for me, was classic presentation in round 1- bilateral shoulder/hips only. This one has had other interesting pains…. Bilateral behind the knees before I went back on meds. So I do think “non-classical” PMR exists, along with PMR plus osteoarthritis.

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PMR just does not seem to have any clear pattern in the way it causes pain.
I have gone from 20 mg to 12 mg. I take my prednisone at 6:30:a.m. I wake up in pain and have to wait about 2 hours until I am pain free. Sometimes my calfs hurt sometimes it os my shoulders, tops of my arms ,wrists and hands.
I’m hesitant to drop the dosage of my Prednisone. Just trying to deal with this without suffering the long term side effects of the prednisone.
My Rheumatologist explained that PMR pain is symmetrical and it certainly with me is.

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Have only had thighs and shoulders aching, along with fatigue. Prednisone has been a miracle so far at 10 mg.

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@biliejo

When I tapered off to 0, my hands were painful and the middle finger of my left hand was very swollen and I could not bend it - it felt like it was broken. As soon as I went back on 5 mg prednisone hands got better

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I've been diagnosed for about a year and an half. Currently on 6mgs prednisone which keeps me functional. I am elderly (79)) and have been a practicing masseuse for a little over 50 years. I ,too, have hand paint suspect that, for me, it is arthritis which I have had mild hints of. It is less painful with the meds, and other long term injuries are also better, will see what tapering does.

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Being 79, I wonder just how much prednisone at 6 mgs (which seems to provide adequate pain relief)will harm me in the long run given that my run may not be more than say5-6 years at the most.

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@salmountain

PMR just does not seem to have any clear pattern in the way it causes pain.
I have gone from 20 mg to 12 mg. I take my prednisone at 6:30:a.m. I wake up in pain and have to wait about 2 hours until I am pain free. Sometimes my calfs hurt sometimes it os my shoulders, tops of my arms ,wrists and hands.
I’m hesitant to drop the dosage of my Prednisone. Just trying to deal with this without suffering the long term side effects of the prednisone.
My Rheumatologist explained that PMR pain is symmetrical and it certainly with me is.

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Have you considered splitting the dose? I take the main dose in the morning, 5.5mg, and a smaller dose of 2mg at 6.30pm with my evening meal. My total dose is 7.5mg and I am reducing from the morning dose, leaving the later dose the same. There is no morning pain.

Most doctors say to take the whole lot in the morning, but that defeats the purpose of treating morning pain which is the biggest problem.

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@megz

Have you considered splitting the dose? I take the main dose in the morning, 5.5mg, and a smaller dose of 2mg at 6.30pm with my evening meal. My total dose is 7.5mg and I am reducing from the morning dose, leaving the later dose the same. There is no morning pain.

Most doctors say to take the whole lot in the morning, but that defeats the purpose of treating morning pain which is the biggest problem.

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Thank you for your input/ suggestion.
I was splitting my dose but my doctor told me that there would be less side effects from the prednisone if you did not split the dose during the day. It hard to know what to do. I am rather new to this. I was diagnosed in September.

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