PMR flare at a drop from 8 to 7 mg of prednisone?

Posted by barracudacool @barracudacool, Nov 26, 2023

Going below 10mg of prednisone has been difficult. The drop from 8 to 7mg of prednisone triggered a major flare of pmr in my hips and right leg. I know that this 8 to 7 drop is a big one for some people. Can’t walk. Went back up to 8mg but flare just keeps getting worse. Tried 15mg. Nothing. This morning I took 20mg to try to eat back the pain and inflammation. So frustrating. I have been doing so well with my drops. And am also on methotrexate. But now yikes. Anybody have any suggestions.

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@barracudacool

Pmr is so difficult. So different for each one of us. I have no pain in my shoulders or arms. All in my hips, legs and lower back. Feels like my legs are encased in concrete. So thank goodness I have you folks. Makes the journey a lot easier.

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Yes ... I agree ... PMR is difficult.

The following link lists some unanswered questions in 2014. To my knowledge, all of these questions are still unanswered.

https://academic.oup.com/rheumatology/article/53/suppl_2/i6/1819999

The American counterparts don't have the answers either.

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When I dropped from 7 to 6.5 mg. I had difficulty so had to go back up to 7mg. I then started dropping by 0.25 every week or two depending on how I did. That has been working for me, it has taken 4 months to get down to 3mg. I notice the drop for a few days and will stay an extra week if uncomfortable or need to rest too much if necessary. No major flares so far so I guess my natural cortisol production is beginning to pick up the slack as the adrenal suppression from prednisone diminishes. Still not a ball of fire energy-wise but I'm willing to take it slow and steady; I really really want to get off the med if possible. Keeping alert to signs of GCA.

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I have had PMR for some years. The up and down on sed rates and the slow taper of prednisone is part of life. I few months go, me sed rate shot up to 48. Now, it is normal and I am tapering of prednisone, at 7mg now. I have accepted that this is the normal for me.

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@barracudacool

Pmr is so difficult. So different for each one of us. I have no pain in my shoulders or arms. All in my hips, legs and lower back. Feels like my legs are encased in concrete. So thank goodness I have you folks. Makes the journey a lot easier.

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Hi, I was looking for this.
My pain is only in my legs.
Needed help getting up from a chair, out of the car, getting dressed.
The diagnosis took long because of the location.
Prednison worked within a day

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After reading many posts I realize that we are all so so unique and different. What works for one person doesn’t necessarily work for another person. My advice to you is to not change any of your medication’s unless you get the advice from your doctor!!! I would call your doctor up as soon as possible and go over everything with your doctor!!! wishing you the very best!!!

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@lindaadel

After reading many posts I realize that we are all so so unique and different. What works for one person doesn’t necessarily work for another person. My advice to you is to not change any of your medication’s unless you get the advice from your doctor!!! I would call your doctor up as soon as possible and go over everything with your doctor!!! wishing you the very best!!!

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So true and I couldn't agree more.

I had excellent doctors who answered all my questions. Sometimes they didn't know the answer but they would say they didn't know.

They always treated me with respect. Sometimes they would stop explaining something because they would think I already knew. To that I would respond to my doctors that they probably knew more than me so explain it to me anyway.

We had disagreements but I tried to disclose everything. Doctors disagree with other doctors so why not disagree with me. Their rationale was usually better than mine anyway.

It is unfortunate some people don't seem to have the same respect for their doctors and vice versa.

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@teri50

Hi, I was looking for this.
My pain is only in my legs.
Needed help getting up from a chair, out of the car, getting dressed.
The diagnosis took long because of the location.
Prednison worked within a day

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Yep. My rheumatologist kept saying that he wasn’t convinced this was PMR because I wasn’t presenting classically. I said buddy I’m as classic as you get. Lol. Like you the proof was in the prednisone working immediately. My sed and c reactive were also both well over 100.

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Thank you for your reply.
Do you also think the prednison working immediately, proofs it is pmr?

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@teri50

Thank you for your reply.
Do you also think the prednison working immediately, proofs it is pmr?

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Excellent question!

I would say if taking prednisone relieves the pain ... that doesn't prove anything.

For example, prednisone helped my knee pain but knee replacements helped more.

Prednisone helped my lower back pain but imaging showed I have severe spinal stenosis.

Prednisone was the only thing that helped trigeminal neuralgia but surgery was eventually done.

All these things had inflammation and pain in common but they had very little to do with PMR.

I am diagnosed with multiple autoimmune disorders and prednisone was used for all of them at one time or another. Prednisone worked faster for these other autoimmune conditions than it did for PMR.

I had to take prednisone for 12 years for PMR. The other autoimmune conditions responded to prednisone and went into remission faster. I could taper off prednisone in a couple of weeks for the other autoimmune conditions after remission was achieved.

It doesn't have to be just one thing. It can be PMR along with something else. That was my problem ... It would have been better if it was PMR and nothing else. I wasn't even aware of some of my problems until I tapered off prednisone. Now I know and I'm trying to address the problems without prednisone.

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@teri50

Thank you for your reply.
Do you also think the prednison working immediately, proofs it is pmr?

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No it was the combo of high inflammation numbers and that the prednisone worked almost immediately. Everything else was non classic but as we all know pmr hits people in different places. Some people have the arm and shoulder pain. This last flare up was just in my right leg/hip. Damn weird.

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