Should I be concerned?

[Summertimegolf]

I am new to your group. Diagnosed with PMR in March. Started with the intense shoulder and girdle pain. So painful! Treated myself with Ibuprofen which helped slightly. My Primary diagnosed it and started me immediately on Prednisone 20 mgm for one month. Resolved pain totally within 48 hrs. Sed rate was 29 . I’m now on 15 mgm and doing ok but started with pulsatile tinnitus 3 days ago. Should I be concerned?

[SnazzyD]

Hello, pulsatile tinnitus can be caused just by a blocked ear, inside or outer canal due to infection, fluid or wax. Really, you need a doc to take a look for you. I know you’re worried about GCA so keep an eye out for other symptoms too like scalp tenderness, unusual headaches/pains and of course sight problems. If your eyes go funny, get to the Emergency room.

[PMRpro Ambassador]

This post seems to have come up twice - so here is the response I gave on the other thread:

That is a very speedy reduction with very large steps down - top experts in tapering say not more than 10% of the current dose each step. This isn't a case of taking pred to get rid of the symptoms and inflammation and then tapering relentlessly to zero to get off pred. You are always looking for the lowest dose that manages the symptoms as well as the starting dose did, it provides your guide. In the early days you are likely to need more than later and it isn't unusual to need 15mg for a few months. One thing you really should try to avoid is going to far too soon and letting a flare happen - for some reason it seems to make getting things under control again more difficult and anyway you have to go back to a higher dose and reduce again so all the perceived advantage of getting to a lower dose has been chucked out of the window.However, your complaint of pulsatile tinnitis concerns me a bit. Pred can cause tinnitus but unfortunately so can GCA. Do please keep a weather eye out and if it gets worse or any other symptoms of GCA appear and you feel worse rather than better as time goes on, please go back to your doctor immediately. You are not enough pred to manage GCA entirely (some doctors will try to tell you any pred protects you, no it doesn't) so it is possible you could be developing it. About 1 in 6 patients with PMR go on to develop GCA at some point - it may be the PMR is a symptom of the GCA at the start or it may happen much later as a flare of the illness.