Started my planned slow taper this am just dropped 1/2 mg and have leg pain.
I plan 10mg and 9 1/2 mg every other day for at least 2 weeks.
Would such a tiny drop cause pain ??
Disheartening but I am determined to persevere. Will be popping the paracetamol !!!
Instant discomfort is usually a sign of steroid withdrawal. This is one reason very slow tapers are recommended. If it's withdrawal it should get better after a few days. I personally found alternating doses, even by such a small amount, was hard for me and I find the dead slow nearly stop taper (DSNS) better but I know many people do alternate. There are a couple of other slow tapers plans which patients have developed which also help ease the transition. If you find after about four days the pain is getting worse, or spreading, not subsiding, then it may mean the PMR inflammation is starting to build up again. Give it a few days to see which way your pain is trending.
It may do - especially if you are very sensitive to change in dose.
I would be inclined to spread the lower dose out, not every other day - but maybe every 3rd or 4th day for the first couple of weeks. If that goes okay then Introduce it on more days.
Or this -
healthunlocked.com/pmrgcauk...
This is great thanks. Will give this a try
It can in very sensitive people. That's why we push the concept of just challenging your body with the new lower dose one day at a time. My version tries the new dose for one day and then you have 3 or 4 days of the old dose you know was OK. Then you try again and have a day less of the old dose. For me it used to take 3 attempts at the new dose before my body accepted it but inbetween I had felt fine on the old dose. And then, as I built up the number of days of the new dose I reached a stage where I felt better on the new lower dose than on the very slightly higher old dose days.
That’s very interesting. I have never got lower than 10 mg. dr tried me on methotrexate but had to stop. Didn’t agree with me 😩. So far paracetamol eased today’s mild pain so will see how it goes. Will try your suggestion if pain persists. Thanks for advice
It took me 4 years to reliably get below about 10mg. Everyone's experience of PMR is slightly different but I believe there are probably at least 4 different versions you could assign the different experiences to, there might be more, and then you need to consider how different people respond to pred. So any doctor who thinks they can use the same procedure for everyone is in cloud cuckoo land. It is wanting to stick to a pre-determined plan that leads to so many problems.
Treat the patient and not the textbook and be willing to slow down a lot and you will have fewer problems getting the patient to a stable and reasonable dose of pred. It isn't rocket science - just clinical skill.
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