Connect
What to expect in the first weeks of PMR do?
Hi Everyone…new here, and one week into my PMR dx and 10mg of Prednisone.
Initially, a few days after taking rx, I felt a little relief, perhaps psychological. But yesterday and today, very sore. My symptoms are predominantly in my pelvic cradle. Although, over the past week, my wrists are feeling it and a little in my shoulders.
Another item is my left knee. About a month from my PMR dx, I had completed by third gel shot. Since my dx, my left knee is really painful, to the point that when I first get out of bed and I can hardly stand on it. Swollen.
Funny thing is, I go to bed fine but wake up in pain.
What should I expect in the first few weeks/months of dx?
Like
Helpful
HugInterested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.
Connect
The first few weeks on Prednisone can be rough especially if your dose isn't high enough. You want to find a "stable" prednisone dose that works for you. Some doctors restrict your prescription so you aren't able to increase your dose without running out of prednisone. If you aren't getting enough pain relief within a week or two tell your doctor so your dose can be adjusted.
Going to bed feeling fine but waking up in pain is a common problem. I think this happens because your Prednisone dose doesn't last for 24 hours. Ask your doctor if you can take a small dose of prednisone in the evening to alleviate this problem.
Prednisone mimics the hormone in your body called cortisol. Your body won't appreciate rapid changes in your Prednisone dose. I think rapid increases in your prednisone dose are just as bad as rapid decreases. You will probably experience prednisone side effects when your dose is adjusted up or down.
In the early going it is more about getting your pain under control. At 10 mg you might need to increase your dose a tad to find your "lowest effective dose." You probably won't need to worry about decreasing your dose unless you have serious side effects from prednisone right from the start of treatment.
I think keeping a journal about how you feel and the changes that happen to your symptoms is a good idea,
-
Like -
Helpful -
Hug
7 ReactionsBefore I was diagnosed with PMR on a PET scan, I did not take prednison and the pain became very severe overnight and in the morning, shoulders, both knees, wrists, fingers . The symptoms do get worse overnight with or without prednison as I am now taking 15mg. The pain in my shoulders and hips are way better but my wrists and fingers are still hurting during the day but worse overnight. I hope this will help you, take care!
-
Like -
Helpful -
Hug
1 Reaction@dadcue Have been messaging my doctor but, understandably, he’s out during this holiday week. I feel that we should increase my dose and will discuss my options, including taking a little at night. Wondering how that may affect my sleep, though. I’m hopeful that there will be a livable solution in the near future. Thanks a bunch for your insight.
@whelchel
Hang in there…..bumpy road, this is a good support group.
As for timing… my Dr had me on 15mg, 10 in am and 5 at bedtime. Big relief.
Sleep was intermittent. Try and walk every day. Exercise helped me, and get a good book/podcast to take your mind off yourself. ( it helped me a lot).
-
Like -
Helpful -
Hug
2 ReactionsI was started with 15mg Prednisone, but still had very bad morning stiffness and pain. I was moved to 20mg am which helped someone what but still woke stiff and in pain all day. What finally worked was 20mg 7am and 10mg 7pm. I slept ok most nights as PMR made me so tired. As I tapered with help of Kevzara I was able to reduce the am dose fairly rapidly, the pm dose was important for me. I am off of Prednisone completely with Kevzara. I do take Tylenol Arthritis occasionally at bed time.
Once you find the correct dose of prednisone you will know it!
-
Like -
Helpful -
Hug
2 Reactions@dadcue Your insight on this terrible disease is always helpful. You and others in this forum help me cope with this disease.
-
Like -
Helpful -
Hug
3 ReactionsI was also prescribed 10 mg of prednisone and did not get immediate relief. I messaged my rheumatologist about upping the dose and he said to be patient. After a couple of weeks, the pain slowly went away and I zoomed on past feeling fine to feeling younger and younger. I was glad I had not upped my dose, as it took another year to taper off. As I tapered I only had one little flare but persevered and started feeling older and older. Sort of a Flowers for Algernon process with my joints and my energy level. I did not have any other health issues to complicate things. Good luck on this journey no one wants to go on!
-
Like -
Helpful -
Hug
2 ReactionsHi @whelchel, as @dadcue says, finding that stable level of pain relief is key, hopefully sooner than later. Take good care of your mental/emotional health too, it is new and unfamiliar territory and finding ways to manage any uncertainty or stress will be helpful. This is a great forum with great support and a wealth of experience and knowledge.
-
Like -
Helpful -
Hug
2 Reactions@ropnrose
The giant cell temporal arthritis never goes away.
It's two blood work that you need to see if your temporal arthritis is inflamed. It is SED RATE AND CRP if they are high your dr will determine if you need to go on prednisone. That is the only medication that helps the temporal arthritis and the blood work go down. Nothing else works.
I am on my 3yrs on infusion ACTEMRA. the first year that I got diagnosed with temporal arthritis I was on injections every week.
@cheifmickey56 Yes, I am aware of this fact. I was diagnosed with PMR and probably GCA in July 2024, based on CRP, ESR and symptoms. I began 60 mg. of Prednisone that month. I have been on Actemra infusions for a year. Tapered to 0, the first week of November 2025.