PMR flares

[Uzziah7]

When you have stressful situation do people notice a flare, then how much do you raise your prednisone level, then how long do you stay at that level

[PMRpro Ambassador]

I have many stressful situations but I rarely raise my dose in response to them. By no means everyone flares just because of some stress so it depends on your relationship with your doctor. If they let you adjust your dose that is OK and a lot of us do adjust the dose to the lowest dose that manages the symptoms. But there is no way to predict what that will be - so it isn't possible to say by how much you might increase the dose.

[Constance13 in reply to PMRpro]

What dose are you on now PMRpro?

[PMRpro Ambassador in reply to Constance13]

15mg - keep trying less but it doesn't work to keep the inflammation down. Even 1mg makes such a difference.

[Constance13 in reply to PMRpro]

Wow! You have had a hard time this year, haven't you. As recommended by you I am stuck on 4mg - with little hope of ever getting off it!

Hope the warmer weather will help you cope a little better. 💐

[PMRpro Ambassador in reply to Constance13]

It's the a/f more than the PMR - except I realised yesterday after a 14mg dose that I woke in a sweat at 4am - which is possibly a sign of the inflammation. Maybe I need to have a chat with Christian! I feel good on the pred but I wonder if there is more going on than there was.

[Constance13 in reply to PMRpro]

You have so much to cope with, especially with OH's health as well. Perhaps you need a complete check-up again!

[PMRpro Ambassador in reply to Constance13]

Heck no - they might find something else!!!!!

[Noosat]

What do you consider a "flare?" As I decrease, I do have discomfit, but I don't consider that or stiffness a "flare." However, we all different and some can manage "pain" better than others.

[PMRCanada]

I flared once when my former rheumy gave me tapering plan that was too fast. She checked my ESR and CRP and sure enough my CRP was elevated. At the time I was at 10mg and I was instructed to go up to 15mg where I stayed for 6 weeks.

I did have some new symptoms emerge after a recent stressful time so I upped 1mg for a couple days and went back down to original dose after that.

I don’t often raise my dose until I have tried other options (Tylenol, hot tub, wheat bag, rest). The one exception is when I travel. The days I’m flying I also increase 1mg.

Hope this helps and the source of the stress can be addressed/resolved.

[Zebedee44]

Hello Uzziah7, good question. I find that stress really makes the pain in my body worse, and has caused me to raise my dose of pred to 10mg from the 8mg I have found effective for the last 14 months.

The doctor wanted me to drop straight back to 8, which I tried and which caused a new increase in pain, so now he has raised my antidepressant in an attempt to reduce my body's response to STRESS. He also suggested that "mindfulness" might help.

Managing PMR, like managing LIFE, is a daily challenge and different for us all. Good luck with your own journey through both.