1. < Polymyalgia Rheumatica (PMR)
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what to expect when starting prednisone for PMR

Posted by tonimcbride @tonimcbride, Jul 31 6:52am

I'd be interested in hearing what others have experienced in the initial weeks when starting prednisone for PMR. I had PMR for 10 weeks before starting 20mg prednisone. Within 4 days I was 85% better, but still unable to do anything that taxed my muscles. Light gardening, walking too fast or too long, still make me sore in the morning, it's just not as bad. Have others had immediate relief on prednisone?

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

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pes25 | @pes25 | Aug 2 1:24pm
In reply to @johnbishop "Hello @tonimcbride, Welcome to Connect. My first time with PMR I also had lived with the..." + (show)
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Hello @tonimcbride, Welcome to Connect. My first time with PMR I also had lived with the pain and stiffness for awhile until it got so bad I couldn't walk and had to use a wheelchair for my appointment with the rheumatologist. I had an appointment in the morning and they drained some fluid from my right knee and I was diagnosed with PMR and given a prescription for 20 mg prednisone. We filled the prescription at the Mayo pharmacy at noon and I took my first dose at lunch. We waited for a couple of hours for a follow up appointment with the rheumatologist that afternoon. I was amazed that I was able to walk out of the appointment pretty much pain free. After that I pretty much had some mild pain and stiffness when I got up in the morning and took my dose of prednisone which would go away within an hour or so. The rheumatologist suggested I keep a daily log of my level of pain when I got up and my dose for the day so that I could use the log to help with my tapering schedule.

I have had 2 PMR flareups with the first one lasting 3-1/2 years and the second one lasting 1-1/2 years. I think movement and stretching of some sort really helps whether it's gardening, walking or exercise. I just had to learn how much I could handle without giving myself more pain the next morning. @dadcue has started some great discussions for learning more about PMR and what helps. Here are just a few that I think you might find helpful:
-- History of PMR -- Interesting video presentation from past to present.
https://connect.mayoclinic.org/discussion/history-of-pmr-interesting-video-presentation-from-past-to-present/
-- Prednisone love/hate support group: https://connect.mayoclinic.org/discussion/prednisone-lovehate-support-group/
-- Comprehensive Overview Of PMR: https://connect.mayoclinic.org/discussion/comprehensive-overview-of-pmr/

How is your PMR pain in the morning if your activity during the previous day was light?

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Thank you for posting the link to the presentation.

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bepsie | @bepsie | Aug 2 5:39pm

I was diagnosed with PMR three weeks ago after seven months of pain and being told it was my lumbar spine and receiving three steroid shots and a nerve block. Obviously they were a waste of time. I started on prednisone two weeks ago. I started on 10 mg a day. Once my blood results came back C reactive protein of 155 my rheumatologist suggested I increase to 15 mg a day. I had relief not 100% but a lot better than I was. I called my doctor to update on my pain and she said to raise to 20 mg. I spread the pills over the day. Honestly, I m so much better. My left arm still aches but much better. I’m back to myself. I know this is the prednisone and realize if I go off if it I’m back at square one but I’m thankful for the reprieve. I feel for everyone with this condition and wish the best

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casinokid1121 | @casinokid1121 | Aug 2 6:45pm

I feel your pain. I started at 30mg/day about 20 months ago. Down to 2 1/4/day. Unfortunately, you may have to be on prednisone 18-24 months. Don't ween of the prednisone to quickly as your pain may come back. Best of luck to you.

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pes25 | @pes25 | Aug 3 7:01am
In reply to @pes25 "I spit the dose (10 in am and 10 in pm). No pain in morning or..." + (show)
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I spit the dose (10 in am and 10 in pm). No pain in morning or night.

Then I read one of these posts and realized the prednisone could be causing my lack of sleep. Yesterday I went to 15 total and took all in the morning. Last night was first real sleep since mid June.

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In reaction to the question, “finished”, That’s all I had in this at this time.

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Mike | @dadcue | Aug 3 8:03am
In reply to @pes25 "I spit the dose (10 in am and 10 in pm). No pain in morning or..." + (show)
Profile picture for pes25 @pes25

I spit the dose (10 in am and 10 in pm). No pain in morning or night.

Then I read one of these posts and realized the prednisone could be causing my lack of sleep. Yesterday I went to 15 total and took all in the morning. Last night was first real sleep since mid June.

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There are many dose splits you can try. You did a 50/50 split. Maybe a 75/25 split or a 90/10 split would help you sleep better and give you all day pain relief.

Since you are on a 20 mg total dose ... Maybe 15 mg in the morning and 5 mg in the evening would be better. That would equate to a 75/25 split dose with the smallest portion always in the evening.

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bepsie | @bepsie | Aug 3 8:47am
In reply to @casinokid1121 "I feel your pain. I started at 30mg/day about 20 months ago. Down to 2 1/4/day...." + (show)
Profile picture for casinokid1121 @casinokid1121

I feel your pain. I started at 30mg/day about 20 months ago. Down to 2 1/4/day. Unfortunately, you may have to be on prednisone 18-24 months. Don't ween of the prednisone to quickly as your pain may come back. Best of luck to you.

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Thank you so much. It helps hearing the experience of others. I will follow your advice. Best wishes to you

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fudge08 | @fudge08 | Aug 3 10:25am

For those of you with a PMR diagnosis and on prednisone, did you have elevated inflammatory labs, sed rate and or CRP. In addition to the pain and sore muscles? My inflammatory labs are normal. Also CK is normal, but ANA titer a little elevated. Doctor is doing additional labs and in the meantime they have started me on a week of 20 mg prednisone.

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tonimcbride | @tonimcbride | Aug 3 10:33am
In reply to @fudge08 "For those of you with a PMR diagnosis and on prednisone, did you have elevated inflammatory..." + (show)
Profile picture for fudge08 @fudge08

For those of you with a PMR diagnosis and on prednisone, did you have elevated inflammatory labs, sed rate and or CRP. In addition to the pain and sore muscles? My inflammatory labs are normal. Also CK is normal, but ANA titer a little elevated. Doctor is doing additional labs and in the meantime they have started me on a week of 20 mg prednisone.

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This sounds very familiar! All my inflammatory markers were normal, with borderline elevated ANA. 8%-10% of folks will have PMR with normal inflammatory markers. 20 mg prednisone made a huge difference for me within two or three days.

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fudge08 | @fudge08 | Aug 3 11:24am
In reply to @tonimcbride "This sounds very familiar! All my inflammatory markers were normal, with borderline elevated ANA. 8%-10% of..." + (show)
Profile picture for tonimcbride @tonimcbride

This sounds very familiar! All my inflammatory markers were normal, with borderline elevated ANA. 8%-10% of folks will have PMR with normal inflammatory markers. 20 mg prednisone made a huge difference for me within two or three days.

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Yes I am feeling improvement! Now I wonder what the plan to taper will look like! Did they put you through additional antibody testing with the elevated ANA?

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casinokid1121 | @casinokid1121 | Aug 3 12:07pm
In reply to @fudge08 "For those of you with a PMR diagnosis and on prednisone, did you have elevated inflammatory..." + (show)
Profile picture for fudge08 @fudge08

For those of you with a PMR diagnosis and on prednisone, did you have elevated inflammatory labs, sed rate and or CRP. In addition to the pain and sore muscles? My inflammatory labs are normal. Also CK is normal, but ANA titer a little elevated. Doctor is doing additional labs and in the meantime they have started me on a week of 20 mg prednisone.

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I was diagnosed with PMR. My SED rate was 55 and CRP was 24. ANA was normal. Thighs, triceps, biceps and traps muscles were extremely sore, could hardly lift my legs or arms.

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