If you take a high enough oral dose it will work too - but the injection provides a high level locally and has far fewer side effects than 30mg of pred. It is one thing doing a fast taper as he has suggested if it is just to deal with an acute problem - but you have PMR and are already taking pred, a high oral dose is adding to the side-effect risk.
I know, but the injection he gave on my left side did not work, and I had to come back and see him. He then prescribed the higher dose of prednisone and a handicap parking sign for my car because I could not walk. Yesterday, I was hesitant that he would inject again and it might not work. I am not able to walk but luckily I have the sign which will help. I will have to start over again with 30 mg for three days and then taper.
Eileen and anyone else trying to come down on seroids....I just thought I would let you know, that for all my slow tapering of steroid....0.5mg every 6 weeks, I hit the brick wall...big time. Pain fatigue ect. I am now going to follow your instructions for lowering the dose...although I was surprised it affected me this way after being on the 5.5mg for 3 weeks, before this happened......fingers crossed.....
This may be your "maintenance dose" - again, however slowly you take a reduction there will be a point where your pred dose is only equal to your inflammation level. As long as the underlying autoimmune disorder is active it will cause inflammation which will cause pain and stiffness. Below that dose - PMR symptoms will return.
And now you are down to where your body is having to wake up and make cortisol for itself too. Have a rest at 6mg until you feel really well.
Thank you for that I will rest at 6mg.....what I forgot to mention last time was, I also had three bad dizzy spells and nearly fainted, wasn`t sure if this was related to coming down on dosage, but saw somewhere that it can happen......who would know something could be so tricky to master, and present such problems!
Several doctors like to keep patients at 5mg for some months before reducing any further just to let the body catch up. It may be you need just a bit more - we are all very different.
And never forget that having PMR doesn't excuse us from any other illness we might fall prey to normally - and if you aren't well for some other reason then it isn't a good idea to reduce at any dose but in this sort of region where you are at the borderlines of cortisol production being taken up by the body again then any stress can be too much. It isn't a race - more haste, less speed.
"who would know something could be so tricky to master, and present such problems" - don't worry, it doesn't seem to occur to a lot of doctors either!!!
Thank you so much for this information.. I was finally diagnosed after 7 months of testing and put on an initial dose of 40ml and after 5 months have reduced to 20 by 5 ml at time. The last reduction was 5 days ago and have been in pain ever since so am going to up the dose by 5 ml because I am a mess again and not able to function properly.. I tried but I guess this is just going to take longer than we anticipated.. no easy way out.. just would so love to get off all the meds.. your input here and knowledge is a source of comfort .. to know that others understand this whole ugly situation is reassuring.. Thanks again for your help...
Oops so sorry I typed in ml but meant mg.
PMR typically lasts from 2 to 6 years for 75% of patients - and for some of us it lasts even longer. And no - no easy ways out, everyone is different except everyone wants to get off pred asap.
If you have PMR then 40mg was a very high dose to start, 20mg is more usual, so I suspect your return of pain at 20mg is less the PMR itself but possibly steroid withdrawal pain at trying to reduce in such a large step at one go. It is recommended by top steroid experts that in tapering each step should be be no more than 10% of the current dose - so 2.5mg usually will work down to 15mg but some people are very sensitive to the change in dose and 2mg or even 1mg is far better and, in the long run, faster because you don't have to go back to a higher dose and try again.
This is a very old thread - so I do hope you are posting on newer ones too as many people leave the forum after so long.
Thanks so much for this Eileen. Can you recommend other sites that are more current?
This site holds a lot of information on different threads.
However, try this website and look at the Newsletters and the Our Little Shop
PMRpro writes informative articles in the Newsletter and also co-wrote 'Living with PMR&GCA'
Oops forgot to put link in
The site is current - it is just this thread that is old. This is a link to the homepage of the forum
https://patient.info/forums/discuss/browse/polymyalgia-rheumatica-and-gca-1708
The first 3 three heading are pinned, the rest are the current threads in the order of the most recent post on them. If you click on one it will take you to that latest post and you can then read the rest.
I have to say - the current moderation of this site seems to have gone crackers. Since the links were to the PMRGCAUK NE website they can hardly suggest it is "unsuitable for inclusion in the forums".