More advice please prior to GP consultation

[Pocketdog]

Hi experts. I upped my pred dose to 20 mg 2 weeks ago believing I had PMR flare after dropping to 15 for 2 weeks. But with your knowledge and experience you suggested Piriformis syndrome - am still struggling with the PS pains but am fortunately having some sports therapy massage and stretching and exercising every day. The road to recovery on this one is definitely taking longer than I expected. I would really appreciate your thoughts/advice on beginning my pred taper as the GP prescribed the jump up to 20mg for 2 weeks for a possible PMR flare. As this hasn't touched the PS do you think I should start the taper or wait a bit longer until the PS symptoms are more manageable? Thanks again

[PMRpro Ambassador]

If you are still inside the 2 weeks and it hasn't made any difference at all you may well be able to just drop back to 15mg. I was on a 6 week taper right at the start - 15 to 10mg after 2 weeks was no problem at all.

I take one single 800mg dose of ibuprofen and sit with a hot water bottle over the painful bit - has a really good effect. It takes hours, sometimes a day or too but together with your physio it might well be a good move.

[Pocketdog in reply to PMRpro]

Thanks PMRPro - I think I will start the taper to 17.5 mg on Thursday and be mindful of the very different symptoms of a possible flare, steroid withdrawal or anything else that may crop up...

[PMRpro Ambassador in reply to Pocketdog]

Since you have been down at 15 before it really shouldn't be hard or need to be very slow

[Pocketdog in reply to PMRpro]

Ok I'll try the 17.5 for 2 weeks. I have a funeral to attend on Wednesday of a close family member so am mindful of the stress and possible flare. I've just got a hot water bottle. Do you think I should swap the co-codamol which I've been taking every day for the last 2 weeks for the PS for ibuprofen?

[PMRpro Ambassador in reply to Pocketdog]

Careful with ibuprofen with pred but taking a single flooding dose with food, gavison if necessary, should be fine - for me the looding dose lasts most of 24 hours without a top-up. It has far antiinflammatory effect than co-codamol that does nothing for me. So it is worth trying. If it isn't any better you don't need to carry on.

[Pocketdog in reply to PMRpro]

Ok will definitely try that tomorrow as have already had a couple of doses of co-codamol- with no effect today - am on lanzaprol as GP reluctant for me to stop taking that right now so will give in to that one - for now - and try to battle against the alendrolic acid next and push for a DEXA scan. Millions of thanks for the advice and voice of experience again

[PMRpro Ambassador in reply to Pocketdog]

You can take ibuprofen alongside co-codamol - different pain relief mechanisms so they don't interact.

[Pocketdog in reply to PMRpro]

Oh brilliant thanks 😊