Pain on reducing pred- normal transition?

[Jude101]

Hi

Newly diagnosed and just gone from 15-12.5 after 3 weeks. Woken up with the shoulder pain again. Is it normal and then settles down again or should I call the gp? I've not been totally pain free on 15 mg per day but it was so much better.

Thanks

[DorsetLady PMRGCAuk volunteer]

Hi,

If pain goes within a couple to three days it's likely to be steroid withdrawal pains. However if it lasts longer, then it's because the drop was too much and you've gone below the level you actually need.

I would think it may be the latter in your case, you really need to be on initial dose for at least 4 weeks, many do 6 weeks. That's gives the Pred a chance to mop up all the built-up inflammation caused prior to diagnosis. The drop from 15mg to 12.5mg is a recognised taper, but many find it just too much.

The fact that you were not totally painfree indicates to me that you haven't got things under control properly. Not everybody gets 100% relief, but it should be at in the 70% range.

Speak to GP, explain your new symptoms including the fact that you still had pain at 15mg, ask to go back to the level and maybe stay on it longer this time around. Also ask for 1mg tablets, so you can taper in smaller steps next time.

[Rugger]

Welcome to this forum where you'll learn a lot and get so much support.

My experience was to stay on 15mg for 2 months, then 13mg for 2 months, then 12mg for a month and so on. We're all different, but it could be that you didn't stay at 15mg for long enough. I agree with Dorset Lady to get 1mg tablets to be able to go slowly, slowly with tapering.

[PMRpro Ambassador]

You have probably tried to drop in too big a step FOR YOU and YOUR PMR. It is also possible that 3 weeks at 15mg simply wasn't enough for you to clear out the accumulated inflammation. Some people need 20mg to do that successfully.