How to address PMR pain while decreasing prednisone

Posted by barbararene @barbararene, Feb 13, 2017

I have been diagnosed w poly myalgia rheumatica (pmr). Am taking 5 mg of predisone, was taking 10mg.
Every time I go on a low dose, symptoms come back. I can't take pain meds, but do drink wine to ease pain, although I'm told no alcohol w prednisone. Anything you can share as far as info

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

@queenie2030

Thank you for your reply. I have been watching my diet for a year now, eating no sugar other than what is in fruit. Less meat more salads. My numbers just aren't going down very quickly. I guess there is nothing quick about PMR. I will try the slow taper soon. I think I can finally determine if my pain is from osteo arthritis which Tylenol helps or PMR. They really are different pains. I keep learning from folks like you My CRP has actually gone up since my diagnosis over a year ago. Good luck to you in being pain free.

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It’s so challenging to determine what’s right or not right as each one of us has our own physiology to deal with. My understanding, and in discussions with my doctor, unless the CRP is grossly high (in my case it was 65 - Canadian testing and I was near to GCA. But down at say 20 CRP mine can be attributed to other inflammatory things going on in my body and also my stress levels. At the CRP level, I tend to lean towards pain and mobility as an indicator ….again this is my situation and only following discussion with my dr.

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This is in reply to the original poster who asked about controlling PMR pain during tapering from prednisone. I have just gone from 6 mg up to 9 because of pain in my neck and shoulder blade area radiating into my shoulders. The higher dose isn't quite taking care of it and I may need to go higher but in the meantime I have tried using a massage ball which brings some pain relief. I'm not sure if it is OK to mention brand names here but you can find them online: an orange inflatable ball with round knobs on the surface, about 7 inches in diameter. I stand against a wall with the ball between me and the wall, lean against it and move my body around to hit different spots. This would probably not be a good idea, though, if you have impaired balance or coordination.

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@linda7

This is in reply to the original poster who asked about controlling PMR pain during tapering from prednisone. I have just gone from 6 mg up to 9 because of pain in my neck and shoulder blade area radiating into my shoulders. The higher dose isn't quite taking care of it and I may need to go higher but in the meantime I have tried using a massage ball which brings some pain relief. I'm not sure if it is OK to mention brand names here but you can find them online: an orange inflatable ball with round knobs on the surface, about 7 inches in diameter. I stand against a wall with the ball between me and the wall, lean against it and move my body around to hit different spots. This would probably not be a good idea, though, if you have impaired balance or coordination.

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Thought I'd interject a question: has anyone had success in treating PMR symptoms with a vibration plate? Studies are all over the place some good some inconclusive...My rheumy said to be careful insomuch as it could inflame osteoarthritis...going forward I've adopted a Keto diet with intermittent fasting (down about 20 lbs so far), closing the rings on my Apple Watch at least 4 times a week and eliminated melatonin - both my rheumy and GP docs were surprised at the impact melatonin had on my symptoms (BTW my bottles of melatonin did not have the autoimmune impact statement)...just had blood work done and the both PMR indicators are all in the green but minor symptoms persist...good news I'm down to 6mg prednisone/day looking to taper to 5 mg/day in a couple of weeks. Less I digress.

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@sashakay

It’s certainly a difficult decision. When I experienced something similar I decided to look at my diet and see what foods would potentially be inflammatory in my body - I omitted all deadly nightshade foods, ie potatoes, tomatoes, etc and also cut down dramatically on high sugar foods. I Eat a lot of plant based foods (not everyone’s choice lol) and I started to feel tons better. It may not work for everyone but for me it was worth a try. CRP down to nearly normal range, minimal pain or discomfort. Good luck 🤞

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Actually, tomatoes have been found to be an anti-inflammatory food: https://pubmed.ncbi.nlm.nih.gov/23069270/

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@queenie2030

I am wondering if it is smart to try tapering as long as your ESR and CRP are still high. After prednisone for a little over a year my ESR has gone down only to 45 and my CRP was 24.99 in January 2022. I tapered down to 10 1/2 mg and had a terrible flare and am now back up to 14 mg prednisone. Will I always flare if my numbers are not in a normal range? Seems inevitable to me and hardly worth going through the up and down with prednisone until those test numbers normalize. Am I correct?

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Hi @queenie2030 have you spoken to your doctor? Do you have a rheumatologist? The prednisone is supposed to decrease inflammation dramatically. Maybe there's something else going on, causing the inflammation, that isn't being addressed by the prednisone. My aunt had Giant Cell Arteritis. She was taking prednisone for it, but she also had an absess in her GI tract that was not diagnosed because the prednisone masked her symptoms.
My Rheumatologist only goes by the CRP. He doesn't think the ESR is accurate. My highest CRP was 10.6, with Giant Cell Arteritis, before I went on Prednisone. Now it's down to 1.2 (on 4 mg of Prednisone). All the best.

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@lmz

Actually, tomatoes have been found to be an anti-inflammatory food: https://pubmed.ncbi.nlm.nih.gov/23069270/

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Thank you interesting info. I understand that this mainly applies for obese and overweight people. But still good info to know. As an RMT I found in my patients that tomatoes exacerbated pain and inflammation with those that experience osteoarthritis- but in saying that we know our bodies as to what works for us. I am learning so much from this group - thank you.

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@novabill

Thought I'd interject a question: has anyone had success in treating PMR symptoms with a vibration plate? Studies are all over the place some good some inconclusive...My rheumy said to be careful insomuch as it could inflame osteoarthritis...going forward I've adopted a Keto diet with intermittent fasting (down about 20 lbs so far), closing the rings on my Apple Watch at least 4 times a week and eliminated melatonin - both my rheumy and GP docs were surprised at the impact melatonin had on my symptoms (BTW my bottles of melatonin did not have the autoimmune impact statement)...just had blood work done and the both PMR indicators are all in the green but minor symptoms persist...good news I'm down to 6mg prednisone/day looking to taper to 5 mg/day in a couple of weeks. Less I digress.

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Hi @novabill, That's great news about your weight loss journey with intermittent fasting and Keto diet. I've been doing intermittent fasting for about a year now and am down about 30 lbs with about 15 or so more to go. I watch my rings on my Apple Watch also and try to close them all every day but don't always make it. It's a great reminder though. There is another discussion that you might want to check out since you are doing intermittent fasting.

-- Low-carb healthy fat living. Intermittent fasting. What’s your why?: https://connect.mayoclinic.org/discussion/low-carb-healthy-fat-living-intermittent-fasting-whats-your-why/

I recently purchased a whole body vibration plate after reading about Teri's @tsc experience with one. I was a little worried when I started using it last week because it seemed to be shaking my eyeballs 🙂 and I wondered if it might not be that good for my knee replacement so I went searching and found this article and feel much better about it. --- Early Post-Operative Intervention of Whole-Body Vibration in Patients After Total Knee Arthroplasty: A Pilot Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912668/

Have you tried the Zero app to help track your intermittent fasting? - https://www.zerofasting.com/

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@johnbishop

Hi @novabill, That's great news about your weight loss journey with intermittent fasting and Keto diet. I've been doing intermittent fasting for about a year now and am down about 30 lbs with about 15 or so more to go. I watch my rings on my Apple Watch also and try to close them all every day but don't always make it. It's a great reminder though. There is another discussion that you might want to check out since you are doing intermittent fasting.

-- Low-carb healthy fat living. Intermittent fasting. What’s your why?: https://connect.mayoclinic.org/discussion/low-carb-healthy-fat-living-intermittent-fasting-whats-your-why/

I recently purchased a whole body vibration plate after reading about Teri's @tsc experience with one. I was a little worried when I started using it last week because it seemed to be shaking my eyeballs 🙂 and I wondered if it might not be that good for my knee replacement so I went searching and found this article and feel much better about it. --- Early Post-Operative Intervention of Whole-Body Vibration in Patients After Total Knee Arthroplasty: A Pilot Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912668/

Have you tried the Zero app to help track your intermittent fasting? - https://www.zerofasting.com/

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Wow...that's a lot of information to unpack...continued good luck and thank you..

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@tsc

Hi @queenie2030 have you spoken to your doctor? Do you have a rheumatologist? The prednisone is supposed to decrease inflammation dramatically. Maybe there's something else going on, causing the inflammation, that isn't being addressed by the prednisone. My aunt had Giant Cell Arteritis. She was taking prednisone for it, but she also had an absess in her GI tract that was not diagnosed because the prednisone masked her symptoms.
My Rheumatologist only goes by the CRP. He doesn't think the ESR is accurate. My highest CRP was 10.6, with Giant Cell Arteritis, before I went on Prednisone. Now it's down to 1.2 (on 4 mg of Prednisone). All the best.

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Thank you for responding to my question. I have a rheumatologist and have had since six weeks after GP diagnosed PMR at the end of 2020. . He does blood work every 90 days. ESR has dropped from 85 to 45 but CRP has risen to just under 25. I am attempting a slow taper again and will speak to him regarding something else going on when I see him in March. No signs of Giant Cell, he told me to watch for it. Best regards.

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@novabill

Thought I'd interject a question: has anyone had success in treating PMR symptoms with a vibration plate? Studies are all over the place some good some inconclusive...My rheumy said to be careful insomuch as it could inflame osteoarthritis...going forward I've adopted a Keto diet with intermittent fasting (down about 20 lbs so far), closing the rings on my Apple Watch at least 4 times a week and eliminated melatonin - both my rheumy and GP docs were surprised at the impact melatonin had on my symptoms (BTW my bottles of melatonin did not have the autoimmune impact statement)...just had blood work done and the both PMR indicators are all in the green but minor symptoms persist...good news I'm down to 6mg prednisone/day looking to taper to 5 mg/day in a couple of weeks. Less I digress.

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Can you send me info how the Leto and other things you have done ? Thanks Lori

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