On my last visit to the rheumy I explained that I'd had a flare when trying to reduce to 9mg after a month on 10. The flare was quite localised (rib cage and sacroiliac joint). He immediately started talking about the possibility of using a steroid Sparing drug if I couldn't reduce. I didn't think of it at the time but wouldn't a better alternative be to continue reducing the oral pred and have a local cortisone injection where it's needed? That would seem preferable to methatroxate. In fact I have been trying the dead slow method and it seems to be working but I just thought I'd see what folk thought of the local injection idea in case the need arises further down the road.