what is the difference

[Suetum]

I understand that as you reduce your steroids you can get withdrawal pain but how do you know that the pains and aches are due that and not the PMR? Are there any clues?

[Celtic PMRGCAuk volunteer]

Suetum, generally any pain that starts immediately following a reduction in steroid dose can be due to steroid withdrawal and we can expect it to resolve within a week or so of our bodies adapting to the new dose. Any pain that starts up to a week or so following a dose reduction and gradually worsens is usually a sign of increasing inflammation.

It can be very difficult judging what is what at first but we do tend to get used to recognising the difference following our own personal experience as we go along.

One thing that is certain is that by reducing in very small decrements and over a longer period of time, it is easier to avoid both the withdrawal pain and the flares.

[Suetum in reply to Celtic]

Thank you, that is so helpful having read all the comments here I have decided to do take the dead slow approach

[jinasc in reply to Suetum]

If you want a copy of both plans, email pmrgcafightersne@googlemail subject heading Reduction Plans and both will be sent to you free of charge.

[PMRpro Ambassador in reply to Suetum]

Which, for anyone looking in, you can find here on this site:

healthunlocked.com/pmrgcauk...

[paddyfields]

Thanks for the following "Any pain that starts up to a week or so following a dose reduction and gradually worsens is usually a sign of increasing inflammation." I got down to 2 mg before my last appointment with the rheumy but my symptoms were steadily coming back. It is interesting that although my rheumy steadfastly hesitates to confirm a definite dx.of PMR her advice is in line with what you indicate as she firmly recommended a maintenance dose of 5 mg although I was reluctant and I am much better again. When they initially make a judgement based on the existence of raised blood markers or the lack of, they don't seem to take it into account if you have already been on the pred. for several months as I had The reason for referral was that I could not reduce past 10 mg pred. without intolerable symptoms returning although from this forum I now realise the GP's reduction was far too fast.