Tapering pains

I am a quite active (gardening, wood-cutting, etc.) 77 year old male. I've had PMR for close to three years. I've been tapering dead slowly and am now down to 4mg/day and proceeding to 3.5mg. I've been wondering what other sufferers experience when tapering, with the major question being whether mild flare symptoms are symmetrical or not. I'm never certain whether my various aches and pains are due to too rapid tapering, adrenal insufficiency, or just overuse of an aging body.

Thank heavens for prednisone!!

Mike-

7 Replies

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  • Hi Mike,

    Well hats off to you for the gardening and woodcutting and for getting down to 3.5 mgs of Prednisalone!

    My guess is, and it's a guess, if you can trace your aches and pains back to the day's activities then they are probably normal. If you feel fairly well in yourself and not exhausted, you're doing o.k.

    Thank heavens for inspirational chaps like you!

  • Well Mike, I'm the same age as you, and do a reasonable amount of gardening as weather permits. Had PMR for just over two years and currently at 5.5mg per day, which I split morning and night.

    If I have been concerned about mild flares, I have just gone back up by a half or so, but really for me it is all about patience; the longer I stay at one level, the easier it becomes to taper again. I am always aware of mild PMR type pain in my upper arms, but nothing which is not manageable, and now when I garden, then there is always some stiffness, which, as a 77 year old, I would have had anyway.

    You have clearly done well to get to 3.5mg, so we'll done.

    Cheers

    Paddy

  • Hi Mike

    Good for you, still active despite getting a bit older and PMR.

    As a relatively 'young' 59 year old and 2 years into PMR, I've found that the physical stuff I would normally do (DIY / washing the car etc) with only a bit of muscle achiness is amplified with PMR. The large muscles do seem to get a hammering - possibly as a result of a combination of the inflammation and being relatively less active long-term? With a flare, I tend to get more pain in my right shoulder / ribs - but that's probably because I'm right handed and use my strength more on that side.

    As for pain from pred reduction (or otherwise)? - quite a few people here say that it's difficult to identify Cause and Effect. But I'm sure you'll get plenty of responses to this one..

    As you say, I suppose many of us also have to take into account that we're not spring chickens any more - even if so in our minds!

    I agree, what would we do without the 'magic' preds (even if we moan about them sometimes!)

    MB :-)

  • Hi Mike

    Now reaching my 4th year of PMR and for past year fluctuated between 1and 2 mg.pred. I can now recognise the PMR pain is different to that caused by my various exercise activities. Mostly feel mine in upper arms especially if I stretch upwards. Had a good journey with pred but can't seem to come off completely. However not worried at low dose . Last GP that I visited cheerfully said some folks need to stay on 1mg long term.

  • Thanks for the congratulatory feedback. However, no-one seems to have responded to my main question for the PMR community: namely, are mild flare symptoms symmetrical (as I would expect strong flare response to be) or asymmetrical?

  • Difficult to say - which is probably why no-one said anything! Sometimes it can start sooner on one side than the other but if you wait long enough it will spread and become bilateral. The same applies to the start of PMR.

    Generally though, if you have definite unilateral problems with, say, a shoulder it is more likely to be something other than the PMR. Myofascial pain syndrome and piriformis syndrome and bursitis can all appear alongside PMR but cause one-sided symptoms. They are also likely to re-emerge as you reduce your dose if they were part of your PMR originally even if not recognised as such but just PMR symptoms that took longer to go. They respond better to targeted treatment than to simply raising the oral dose.

  • Mike, I would say PMR / mild flare symptoms are generally symmetrical - although any symptoms (pain especially) can be amplified on one side or another depending on the type and extent of physical activity you engage in whilst having a flare - or even if not.

    For example, if I do car washing / polishing or DIY when experiencing low level stiffness / pain, since I use my right arm and shoulder muscles more, I get more 'feedback' on that side. I think it's just those muscles saying 'steady on now!'.

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