How long do flares usually last?

[suzy1959]

I have been on Pred. for 6 months , having started on 15mgs. I got down to 9.5 at the beginning of May but then had a flare and have slowly been increasing my dosage to try to manage the symptoms since then. I got up to 15mgs on 31st May. Every time I have increased, I have felt better within 3 days, but then the effects seem to subside. Yesterday, having had quite a busy weekend, I felt terrible again and am getting lots of aches and pains too. I am very reluctant to take more Pred. , especially as I have just begun to take Methotrexate to help me reduce the Pred. So I was wondering how long I might expect this flare to continue so I can work out if I can cope with these pains and fatigue for now? This flare has shown up in my blood tests, but the last one, 10 days ago showed a slight reduction in inflammation. I will have another blood test in a week.

[polkadotcom]

It's a 'how long is a piece of string' question, Suzy. I feel that you have been doing it the wrong way round by keeping increasing by small amounts rather than beginning on a blockbuster one to keep the inflammation under control and then going down in small amounts rather than up all the time.

I've had flares which have lasted for a couple of days and flares which have lasted a couple of months. When I've had one, I've no idea at the beginning which it is likely to be.

I understand your reluctance to raise the Pred dose to keep you comfortable while the Metho takes effect but I think you should talk to your medics about the situation. See what they say and I hope you feel better soon.

[suzy1959]

Thank you for the reply. I have been doing this the wrong way around because I didn't know any better! My GP just agrees with me and the Rheumy is always wanting me to reduce even when it is clear I am flaring. His most constructive suggestion has been to try MTX which I am doing. Neither has ever suggested the best way to deal with a flare. On the day I wrote the question I was feeling especially bad and have recovered a bit now which makes me think it was probably a case of overdoing it as we have just got a new puppy. Whether coincidence or not, since starting the MTX, my energy levels seem to be more up and down.

[polkadotcom]

Glad you are feeling a bit better, do hope it continues like that. I don't know where you are but to try you on MTX after just six months seems OTT to me, I was on it but that was after 8 years. It worked for the first year but then I had a big GCA flare and after that it was noticeable that I wasn't getting any benefit - basically it just stopped working so I came off it after 2 years.

It seems to me that you are being pushed to reduce the steroids far too quickly and very often that increases the probability of flares. I suggest that you take some time out to read the information on this website and read the current guidelines for treating PMR and/or GCA and then take them along with you to your Rheumy and ask him to read them too.