Pain returning...need advice

[izzyart]

Help!...I am tapering slowly from 10 to 9 mg predinsone and traveling...had awful flare up a few days ago..back pain, sore joints, now am back to 10 mg but still aches and stiffness...should I increase?, if so, what amount?

Thanks,Pat

[Oxford8]

I'm finding coming down from 10 to 9 the most difficult. I think the clue is in the travelling. I had a very stressful day coming up last week do I upped the dose by 1mg for couple of days and it did the trick. Back down to 9.5mg and all OK.Good luck. 👍🌷

[izzyart in reply to Oxford8]

Thanks, just knowing this makes me feel better!

[PMRpro Ambassador]

As advised by quite a few rheumatologists and a tried and tested approach: I'd try adding 5mg to the dose where I flared for up to a week and then drop back to the dose I was tapering from. And wait to start the taper again until you are home. It is never a good idea to mix a change in habit with a taper, however slowly.

[Oxford8 in reply to PMRpro]

Hi PMRpro. Not quite sure what you're saying in your last sentence. Are you saying it's not good to take an extra mg of pred if going into a situation which you know is going to be physically and mentally stressful? Not challenging - just trying to understand.

Thanks.

[DorsetLady PMRGCAuk volunteer in reply to Oxford8]

No, what PMRpro means, I think, and what advice I would give, is don’t taper just before or during travelling - or doing anything else that you know is likely to be stressful. A change in your normal routine.

Personally I didn’t taper before a holiday, or Christmas for example.

Sometimes we do recommend upping the dose a little just before a stressful event - say if it’s going to last just a day or so.

[Oxford8 in reply to DorsetLady]

Thanks DL. That's clear. 🙂

[Valnvaughan in reply to Oxford8]

I had 2 days in London last week. Lots of extra walking and museum visits. So added 2 mg Pred to my regular 3 mg dose for those 2 days. Then dropped back to 3 mg Pred on return home and had a total rest day. Worked well ...feel fine....no nasty symptoms. Valerie

[Oxford8 in reply to Valnvaughan]

That's good to know VV. Thanks. 👍

[PMRpro Ambassador in reply to Oxford8]

Exactly what DL says - don't add in extra potential activity/stress AND try to reduce the dose at the same time. In fact - if you go into such a situation it is probably a far better idea to ADD a mg, not try to go lower!

[Oxford8 in reply to PMRpro]

Thank you. I understand now.

🙂

[izzyart in reply to PMRpro]

Thanks pro,

Since I am traveling for another month, should i up dose to where the pain is gone? And taper slowly when I am home to where I started on the trip?

Pat

[PMRpro Ambassador in reply to izzyart]

I would. If you are having pain due to PMR you are on too low a dose. However - bear in mind that some pain MIGHT be due to you asking too much of already unhappy muscles.

[izzyart in reply to PMRpro]

Thanks pro...it worked!

[Purplecrow in reply to izzyart]

Agreed!!

5+ years of PMR have taught me that the taper is not as important as managing the inflam. When traveling or other stressful events...proactive extra mg pred is better than igniting a flare....just sayin'......Jerri

[PMRCanada]

Tapering from 10 down to 9mg took a couple of tries for me. Ended up at 9.5 for a month, then slowly introduced 9. Managed 9 for awhile before going on vacation. Took 10mg the two days we flew but was at 9 the rest of the time away, and now that I’m back. Will stay at this dose for at least three weeks before tapering again.

Below 10mg is proving slow and tricky at times, so I’m dropping only .5mg about every month or so.

Good advice already provided by others on here. As they’ve mentioned, not best to taper when travelling or during times that may cause additional stress or activity. ATB moving forward.

[izzyart in reply to PMRCanada]

Thanks Canada, good advice...I took an extra mg this morning and it made a big difference...will keep on the 11 mg a day until we return home. A two month setback is better than pain.

Pat

[PMRpro Ambassador in reply to izzyart]

A 2 month marking time in reducing isn't a setback - letting in a flare that means going back to a higher dose is a setback ...