Lady 74

[Tiramisu76]

I've headed my post 'lady 74' so there is no confusion - my tag looks like I'm a 49 year old man. A week or so ago I took your advice and asked my GP if I could go from 15 to 20mgs Pred. As I was having some stiffness and pain. She agreed, but told me to come straight back down if there was no improvement as she feels there may be other things going on ( I already know I have a spine that's suffering from wear and tear). I have noticed some improvement but think my backache is not pmr. Should I go straight back down ( I've been on it a week and that's OK my GP says) or decrease to 19 and then to 18 after a week. Don"t know what to do! Help! I suffered from avascular necrosis 2 years ago when l was on Pred.

[HeronNS]

I believe in this case your doctor is correct. If the higher dose hasn't helped and you've only been on it for a week it should be safe to drop back. It's when you've been at the higher dose for longer it gets more difficult as then the old pred withdrawal symptoms kick in.

[PMRpro Ambassador]

I think you should be fine to drop back to 15mg. On the other hand - if you DO feel some improvement, why not give it a week at 17.5mg on the way? Obviously there was something going on that is benefitting from the dose being higher than 15mg.

[Tiramisu76 in reply to PMRpro]

Thank you. I think that is what I want to do. How long should I take 17.5 for?

[Tiramisu76 in reply to Tiramisu76]

Sorry, You did say a week!

[PMRpro Ambassador in reply to Tiramisu76]

If it were me I would stay at 20mg longer since I felt better - but you could also stay at the 17.5mg dose while you notice continuing improvement. It might be one week, it might be longer. it is impossible to say. It is so difficult to say what someone else should try - you have to feel your way a lot of the time. What is important is that you are experiencing an improvement on what you were before.

[MaryA_ in reply to PMRpro]

Good advice PMRpro, I too have had to increase prednisone from 4mg to 20mg to get back on track. Will stay on higher dose a couple of weeks n if I feel well enough will drop to 17mg. I think doc had me drop too quickly, so we came up with this plan.

[Tiramisu76]

If I stay on 20 I would I then have to reduce to 19 or could I do 18 after 2 or 3 weeks? Thank you for all this advice.

[jinasc]

Reduction plans available, free of charge from [e-mail]

Also there are other steroid plans on this site - look at the Steroid Reduction Plans in the Pinned Posts. Top right hand side of this page.

[SheffieldJane]

Did you experience an improvement?

You will be no further backwards or forwards after a week Russell49. You can stop. I'd be cautious because of the adverse side effects you have endured. The back pain needs some further investigation. Oh good luck!!!!

[Tiramisu76]

Thank you. I think I know from previous X-Ray's that my back pain is due to deterioration of my spine. Even so, it does feel better on 20mgs. I think Pred.probably helps with pain from other causes. I am tempted to stay on 20mgs but because of my previous adverse side effects will try 17.5 as suggested by PMRpro and see how I go.

[PMRpro Ambassador in reply to Tiramisu76]

I have been told in the past by orthopedists that my back pain is due to derterioration of my spine, In fact the pain was entirely due to spasmed muscles. Now they have been sorted out - that pain is gone 99% of the time. When it returns due to myofascial pain syndrome it is very easily brought under control now.

[Hidden]

I have similar back issues. I have not noticed significant improvement on pred. But painkillers and amitrytiline help back but not PMR symptoms. Don't know if that helps or hinders! Pain can be very subjective as experience. Hope relief comes from something.