I have had PMR for some months now, and have very little pain when I take 15mg of prednisolone. As soon as I try and drop any lower I have a flare up, and my shoulders and arms are very sore.
Does anyone know if it causes any problems to stay on 15mg?
Thanks
Grace
hi can you tell us how much you are reducing it may be you are going down to quickly,i never got beyond going down at 1mg at a time lots depend on the individuals body !!and condition never believe the set ideas that are quoted slow but sure is the way forward listening and responding to your body and,symptoms please can you ,give us more info i am sure eileen and others will help carolk
Grace, you should not need to stay on 15mg indefinitely as you are putting yourself at unnecessary risk of side effects at this dose long-term. I wonder if you are trying to reduce too steeply? Some people have found that if they are having difficulties reducing from 15mg after a few weeks, reducing by just 1mg at a time can help. Have you tried this?
A rheumatology Professor in Bristol is putting patients on 15mg for 6 weeks, followed by 12.5 for 6 weeks and then 10mg for 52 weeks with following reductions at 1mg a month. This reduction programme seems to be proving successful in that his patients are suffering less flares as they reduce.
If your arm/shoulder pain is returning immediately following a reduction, then have you tried waiting a week or so to see if it subsides as it could be down to steroid withdrawal pain as opposed to returning inflammation? If the pain starts returning some days after the reduction and then continues to build, that can point to a flare.
MrsO
Good morning,
Thank you for answering me so quickly.
My blood tests on 09/01/2014 were normal, but I was still very sore. It first started in December when I broke my shoulder, and have been in pain ever since. I started taking 15mg of prednisolone in December and found great benefit, and then dropped to 14mg, then 13mg and the one day at 12mg brought the pain back. I then had to go back to 15mg. I saw on an internet site that the recommended treatment for PMR is 15mg for 6 weeks, 14mg for 6 weeks then 13mg for 6 weeks. Then reduce by 1mg every six weeks.
Hope you can advise,
Regards,
Grace
P.S. My doctor phoned me one night after more blood tests, and told me I had PMR
Grace, it really does sound as though you still could be suffering the after effects of the broken shoulder which may be complicating things. However, if you dropped to 14mg and still felt fine, and experienced the same at 13mg, it is possible that you then went too quickly to 12. You could try going back to the last dose at which you felt comfortable, be it 14 or 13 and see if that helps - it seems as though you might not have been remaining on each new dose for long enough.
MrsO
Good afternoon MrsO,
I think you could be right, and I intend to take things much slower, and hope that dropping my 1mg at a time is the way to go forward.
Regards,
Grace
I find that I can only reduce by 1/2mg at a time. Even then everytime I get to 13mg I have a flare up so I am going to try and stay a bit longer at each reduced dose. Don't try and do it too quicly. I have been on them for 21/2 years although I did start on 30mg as I had temporal artritus with it. The most important thing is to be pain free and able to function properly. Good luck to you
Carol
Hello again Grace
Be sure not to drop the dose immediately you feel well but stay on it for a good few weeks just to make sure that the new dose is keeping good control of the inflammation - remember that the steroids are not curing PMR (sadly there is no cure at present) but just containing the inflammation that causes the pain.
Another tip is not to reduce when a busy time is looming but wait until you know you can clear the decks for a week or so to give the body chance to adapt to the new dose.
Good luck!
MrsO
Carol
Yes, as you have found, the secret is not only in smaller reductions but also extending the time between those reductions. Also, the smaller the reduction, the easier it is to see at which point the inflammation might be running away meaning that the previous dose is the best one for you, for now. Wise words in your last sentence and I couldn't agree more. Good luck on the slower taper.
MrsO
don't worry if you are going down at 1/2 a mg I had the same experience and stay on each dose until you are settled then try again bearing in mind to pick a quiet week !!!it takes at least a week before you are sure the lower dose is ok ,this is not a race and there are no prizes for rushing ,and reduce on your terms only you know how you feel and if you have any committments etc that could put you under pressure stay on the dose that is holding the symptoms ,ps don't be unrealistic about the phrase pain free that's a myth,you are striving to be able to cope with a reasonable lifestyle that is probably less active than before good luck carolk
Thanks Carol find some days I also have to resort to the good old paracetamol. I think I have played down the PMR to my family and friends which was probably a mistake as they will say what you got to be tired about your retired!!! I have tried in the past to reduce dose quickly as I am diabetic but have finally found the middle way. I have found out so much more on this forum than any doctors advice. Thank you all so much.
CarolP or Mousemum