Fatigue and aching in pelvic girdle

[Athena2020]

I have been tapering my prednisone 1 mg per month , I am at 7 mg now . I am feeling tired and sleepy especially in the morning to early afternoon before I take my meds . I also am having pain in my legs and pain in pelvic girdle when doing housework and walking . Has anyone experienced this ? Could it be the reduction in prednisone ? Any suggestions would be helpful thank you

[squashie]

My guess is that you've overshot your taper. It's not that you won't be able to get any lower, but for now you probably need to be on a slightly higher dose. Recommended reductions are no more than 10% at a time, so the 1mg month reduction is likely a bit steep. If it were me, I'd try an extra 5mg a day for 2 or 3 days to see if that clears the inflammation. If it does then go straight back to the level at which you were last symptom free and stay there for a month. Then, assuming all is well, try a 1/2mg drop, and reduce by 1/2 mg each time from here.

At 2 years in, I'd reduced to 2mg. I went to 1 1/2 and ended up with recurrence of symptoms. I added 5mg for a couple of days, with complete success and have slowly tapered to 2.5mg at the moment.

No doubt when Europe wakes up you will get similar responses from the experts. Good luck.

[Athena2020 in reply to squashie]

Thank you very much for your suggestions

[DorsetLady PMRGCAuk volunteer]

Good advice from squashie......nothing much to add, except maybe stay in the higher dose a little longer say 5-7 days, and use a slow taper in future, once you get back on track, Adrenals will soon be coming into play, if not already, and that sometimes makes life a bit more difficult - healthunlocked.com/pmrgcauk...

[Athena2020 in reply to DorsetLady]

Thank you I agree

[PMRpro Ambassador]

Is the leg and pelvic pain like the start of your PMR? Or is it just you are trying to do too much?

You are never reducing relentlessly to zero - you are looking for the lowest dose that gives the same result as the starting dose did. It may be that that is 7.5mg for you at present. It doesn't mean you won't get lower, just not yet. The PMR wasn't cured at higher doses, just the inflammation it caused was being managed very well. Your muscles and soft tissues around the joints are still being attacked by the autoimmune disorder and if there is a bit of inflammation hanging around it will make you feel worse.

You are also now at the sort of dose where for some people the fatigue associated with slowly returning adrenal function becomes a factor.

1mg is now more than the suggested 10% of the current dose - and that is a lot for the adrenal function to make up too, it takes time for the feedback set-up to adjust. That is especially the case if you go from every day one dose to every day a lower dose from one day to the next. Using a slowed taper helps, as does reducing the step down to1/2mg.

healthunlocked.com/pmrgcauk...

is one way, there are others.

[Athena2020 in reply to PMRpro]

I did not have pain in my pelvic girdle in the beginning of my PMR . This fatigue and pain started just recently . I will talk to my dr regarding upping the dose . Thank you for you suggestions .

[Mary63]

I got pelvic pain about two years ago on a reduction from 7.5 to 7. I had not had pelvic pain as part of my PMR before, so sat on it for a couple of weeks. Went up to 12 mg for 5 days and then back down to 7.5, and haven’t had pelvic pain since. Now down to 5mg. You might be on too low a dose at present I guess?

[Athena2020 in reply to Mary63]

Thank you for your reply I will discuss upping the dose with my dr.