PMR Dosages and Managing Symptoms

Posted by maryft @maryft, Aug 16, 2021

I've read through the discussions and note all the different dosages of prednisone, different lengths of time taking prednisone, plus the addition of other meds, for PMR. I also note that the tapering of dosages and time frames are so varied from person to person. It appears there is not a set standard among physicians. How does one know if they were/are receiving the right dosage? Obviously, if symptoms subside, the dose is working, but after tapering if the symptoms return, was the initial dosage correct? I've also read that a person shouldn't be on prednisone long term, but there are many who've been on it for a few years. Its all very confusing.

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@pjnewm

I was doing pretty well on 5 mg of prednisone a day tapering it down from 16 mg at one time approximately a year and a half ago. I believe I’m having a flare and I suspect I need to increase my prednisone and I am wondering about how to go about it. Should I go up in 5 mg increments or less and if so, what is a common dose that takes care of the flare?

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Hi @pjnewm, Tapering off of prednisone and managing the pain can be difficult. You will notice that we moved your post to an existing discussion on the same topic here so that you can meet other members that are sharing what has helped them.
-- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/.

l'm glad to see that you have already heard from @avidhiker with some suggestions that I have also used when struggling while my PMR was active and I was tapering. I think listening to your body and tapering slowly is key.

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Does anyone else have morning pain in shoulders and neck that subsides after about an hour despite being on prednisone??

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@copeterson

Does anyone else have morning pain in shoulders and neck that subsides after about an hour despite being on prednisone??

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I'm not sure I understand your question @copeterson. Do you mean you wake up with the shoulder and neck pain and then it goes away after you take your morning dose of prednisone?

When My PMR was active, I always had some minor aches and pain in the morning when I first got up. It always felt better after moving around for a short period of time which was before I took my morning dose of prednisone.

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@johnbishop

I'm not sure I understand your question @copeterson. Do you mean you wake up with the shoulder and neck pain and then it goes away after you take your morning dose of prednisone?

When My PMR was active, I always had some minor aches and pain in the morning when I first got up. It always felt better after moving around for a short period of time which was before I took my morning dose of prednisone.

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Yes. I have never believed that the prednisone dose actually mitigated the pain, rather the moving around did.

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@copeterson

Yes. I have never believed that the prednisone dose actually mitigated the pain, rather the moving around did.

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Seems easy enough to figure out - what happens if you don't take the days prednisone dose? Does the moving around still keep you pain free all day?

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Haven’t tried that- my interest was learning if the morning discomfort was common.

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@copeterson

Haven’t tried that- my interest was learning if the morning discomfort was common.

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Sorry, I misunderstood. I think it's quite common to have some morning discomfort the next day until you move around some and then take your next dose. That was one of the reasons that keeping a daily log was useful when it was time to taper to the next lower dose.

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Thank you! Seems logical. I was under the impression the residual level of prednisone on our systems after 12-24 hours is effective. In my PMR world mornings are no picnic.
I’m curious know what will happen if I wait. Thank you for your thoughts and ideas!

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@copeterson

Thank you! Seems logical. I was under the impression the residual level of prednisone on our systems after 12-24 hours is effective. In my PMR world mornings are no picnic.
I’m curious know what will happen if I wait. Thank you for your thoughts and ideas!

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Some members have found that it helps to split their dose between morning and late afternoon/evening to lessen the early morning pain/discomfort.

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I have a report to make: I have been complaining for some time now that my thighs hurt while bearing a load. Due to a mix-up, I have been off my Low Dose Naltrexone for at least ten days. Everyday my legs got worse to the point of struggling to walk. I wasn't sleeping well either. I got my LDN back and in two days my legs are much (at least %50) better. And I am sleeping more normally, too. Are my legs "cured", no. But I don't know what was wrong in the first place. My upper body is fine and my markers were good when last checked. And the EMG came up negative, too. Sure seemed like PMR but only my legs? See my rheumy in a few weeks and we will see what he says.

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