Is this a flare up of PMR

[Hayling1]

Advice please about a possible flare up- I was diagnosed with PMR last December and given 20mgs of Pred. I went to Spain in February and slowly I was able to decrease to 5 mgs which I’ve taken now for 8 weeks, but I’m feeling the return of shoulder and neck pains - pain I recognise as PMR, it’s like no other, my hips hurt this time too - can anyone suggest how I may be able to manage this myself? I haven’t seen my GP since last January and due to lock down I haven’t attempted to visit

I wonder if this is my first flare up?

[PMRpro Ambassador]

You have almost certainly flared because you have reduced too far - to get from 20 to 5mg since December is very fast, it takes 18 months on average to get to 5mg!

However, if you have been on 5mg for 2 months it is obviously only a little bit too low unless this is an increase in disease activity, which is a possibility if you have extra symptoms now. If it were me, first I would try a few days of 10mg and drop straight back to 6mg and then see how it goes. Have you been doing more?

[Hayling1 in reply to PMRpro]

Thank you for your reply- I did take 10mgs this morning as I felt worse than yesterday and dread the thought of going back to square one! How many days do you think I should take 10 mgs? I took 6 mgs yesterday with no effect at all

[DorsetLady PMRGCAuk volunteer]

Ditto to PMRPro’s comments.

[Hayling1 in reply to DorsetLady]

Thank you for your reply. I took 10mgs this morning and hope this will control the pain and prevent a relapse that I am dreading!

[DorsetLady PMRGCAuk volunteer in reply to Hayling1]

I would stay there for at least 5 days, and if everything seems okay you should be able to drop back down to 6mg.

If it’s not okay by day 5 you may need to stay a bit longer.

[Dilly-B]

This is such an amazing group. Look at how much support and advice is offered from people who know and care! The second reason is that you find people who are having similar experiences. I really understand your question - is this my first flare up because I just asked myself the same. (I was diagnosed with PMR end of Nov). I upped my Pred on Saturday am when I finally realised it was a flare.

My question is - how long can we stay at this higher dosage and then reduce back to where we were feeling well before the flare - before needing to taper slowly again?

[PMRpro Ambassador in reply to Dilly-B]

Up to 10 days or so - it's just the same as a short course of pred, just the baseline is higher.

[Dilly-B in reply to PMRpro]

Thank you. That is a very big help.