PRED advice

[BRANTwood1949]

HI NEED SOME advice on pred for 2week at 15, 3 weeks at 20, then upt to 25, for 4 weeks , still having days of neck pain 2 to 3 then 2to 3 ok . if i go to 30 and the pain stops how long do i need at that level till you start to reduce down should you be pain free that is

[DorsetLady PMRGCAuk volunteer]

Hi,

Have you increased the Pred yourself, or under medical advice? If you are doing it yourself then you really need to speak to doctor - you shouldn't just keep increasing the dose willy-nilly.

If you are at the correct dose, then you should get at least 70% relief from the drug within days, some lucky people get 100% relief, but that's usually on the initial high dose.

Most people stay at the original starting for month before thinking about reducing, that allows the Pred to get control of the inflammation/pain caused by the underlying PMR.

You may not be completely pain free, it varies from person to person, but certainly you should be able to have a reasonable quality of life.

A bit more information on symptoms pre diagnosis etc might help, if you have neck pain then maybe you have GCA rather than PMR, and if that's the case then your starting dose of 15mg certainly wouldn't have been enough.

[Sandy1947 in reply to DorsetLady]

Why is it on Friday my Doc let me increase from 20 mg to 25 mg (15mg at 5:00 am 10 mg at 5:30 pm) because the shoulder pain was terrible. I felt amazing 100% pain free on Sat., Sun shoulder pain returned (not as bad as on 20 mg) and today I have pain in arms btwn shoulder and elbow. All pain is bilateral. When is this going to level out? I'm sure I need higher dose but she is trying to get me better on a dose as low as possible because of osteoporosis. My friend PMR arrived June 19th. I have had enough! Ha!Ha!

[PMRpro Ambassador in reply to Sandy1947]

Did you then go and do "things" because you felt so well?

[Sandy1947 in reply to PMRpro]

No. I'm afraid. Every day I lie down at 2:00 pm and day is done. Some days, like today, I actually get into bed.

[PMRpro Ambassador in reply to Sandy1947]

Try having your rest s a bit earlier - before you get so tired. It is all about pacing -

healthunlocked.com/pmrgcauk......

[Celtic PMRGCAuk volunteer]

Hello BRANTwood, I agree with DL in cautioning about increasing in the way you have if it is without medical advice. If the usual 15mg starting dose doesn't greatly relieve symptoms in a week or so, then either the dose is not enough or it may not be PMR. Sometimes, a Dr will increase the dose slightly to see if that achieves a positive result, but more than 25mg is not recommended. I think we need some more information, ie symptoms, blood test results, etc before trying to advise you further, but really you need the advice of a doctor, and don't hesitate to seek a second opinion if necessary.

[Charlie1boy]

Hi,

In my case, I was started on 20mg, and was increased by my GP to 30mg after three days to get the pain under control. It worked for me, and I stayed at 30mg for a further three weeks before starting to taper down.

Having said that, you will note that the advice came from my GP, so I endorse fully what others have said re consulting again with your GP..

Good luck

[PMRpro Ambassador]

It is very unusual to be totally pain-free with PMR at any dose, as has been said, about 70% better is a good start and it should get a bit better than that, but it may not. Overall my symptoms were about 80% better within a week - but that was including the stiffness which was gone altogether. It was several months before the hip, foot and hand pain faded altogether and they still stick their heads above the parapet at intervals. That's after 8 years on pred!

Neck and shoulder pain are often persistent - and often not directly to do with the PMR itself. But increasing the dose like that is possibly confusing the issue. There is a lot to be said for starting at higher than 15mg and not messing about - but I doubt 30mg will make a significant difference after this time, you should be considering starting a a slow and careful reduction by now.