I have had PMR for 4 years and by using the DSNS method of tapering, I have been able to decrease to 1 mg of prednisone a day. I have now had a major flare and I am almost back to the ESR number I had when diagnosed. How many mgs of Prednisone should I start taking now in order to start reducing all over again.
I also got down to 1 mg.. and 2 months ago had a major flare after an injury. I went to 5 mg for 2 days.. then 4 for 2 days.. and now I’m at 3 mg. I’m going to stay at 3 mg for the rest of the summer.. then start down again this winter. I’m still a bit sore in the shoulders but NOTHING like the major flare. best to you..
Thank you so much - I thought maybe I would have to start all over again. And, it would take me another 4 years to get stabilized.
what is DNSN Method?
my rheumatologists lowers me me mg each month..and bumps it up 5-6 mg for any symptoms..
It’s a method of tapering prednisone and is pinned on the board. I’ve yet to try it but understand that because its so slow it helps to differentiate between a flare or prednisone withdrawal symptoms.
Hiya I went down to 1pred in January this year i had a bad flare ,so whammed it up to 7 mg now , down to 6mg I will reduce it to 5 after the summer , my doctor told me that 5 mg is the bodies own amount that it would make if things were normal , so I battle on as we all do ,good luck x
As someone has said it is a way of spreading a reduction step over more time so the body notices it less. Dropping too much for you personally at one time can cause you to overshoot the dose you need or cause steroid withdrawal pains - which are so similar to the reason you are taking the pred in the first place that you think it is a flare. The smaller the change at any one time, the less the body complains and the quicker it gets used to the new dose.
Thank you so much - this is the first flare I have experienced in the 4 years I have had PMR so no experience.
Thank you for your help.
It’s a way to reduce your prednisone dose - DSNS means “down slow, nearly stop” - the method has worked really well for me for 4 years, and this is the first time I have experienced a flare.
and leaves you there to start reducing all over again or is the bump up for a few days? thank you
a pmr friend of mine did that–started all over at 20 which was unnecessary. his doc guided him. set him back years.
Hi Susan, after having too many flare, normally over doing it, I found out what works for me; what ever dose I am I double it for 3 or 4 days, still not PMR pain free, triple original dosage for 3 or 4 days, still not PMR pain free quadruple original dosage. Then when I am PMR pain free reduce using the same method. Then when at the original dosage stabilize for a week or so before starting my tapering. I believe the key is to get ahead of the inflammation. Good luck 
Thank you so much for sharing - I really appreciate it. I have a doctor’s appointment this week, and I wanted to have some suggestions that might work when I get there - sometimes doctors get in a rush. What is working for you seems very reasonable.
That’s what I am worried about - I am so glad to get some personal experiences from others on this forum so I can have some alternative suggestions when I see my doctor later this week. Thank you for sharing.
Susan, you are welcome I hope it works for you. My worst flare was when my Rheumy was rushing me off Prednisone now I take slow and easy, it is not a race. I ended up taking more Prednisone because I was rushing.
I think that is a typical Rheumy thing - Thanks again.
I hate to say this but it sounds like you are being set up for a yo-yo situation. If you are repeatedly getting symptoms which require an increase of 5 or 6 mg to resolve it seems your overall rate of taper is too fast. A slow enough taper may not completely eliminate the odd bump but if done carefully enough the way should be much smoother and result in a lower cumulative dose of pred.
Judith, I agree with Anhaga, sounds like you are yo-yoing are you reducing with DSNS in small amounts?