Should I up the pred?

[oscarandchloe]

Hi, I need quick advice. Have been reducing using Dead slow method from 10mg starting about November last year (for PMR) after being on 10 mg since March 2020 and now got down to 6.5/7mg. I had lovely easy garden visit on Monday of this week and felt really free of stiffness. The next morning I was stiff right across my lower back, this hasn't eased off and this morning it's worse so I can't bend down without real discomfort. Isn't this rather long for exercise stiffness to persist, let alone get worse? I'm tempted to try a dose of 15mg this morning to see if that has an effect but very loathe to up the pred having got this far. Any advice appreciated. Thanks to all you lovely people out there who help us through this horrible disease.

[DorsetLady PMRGCAuk volunteer]

You could try 15mg for 2-3 days to see if that helps- and then drop back down 7mg.

But just because you are on the DSNS taper (or any other version) you still won’t get below the dose your illness actually needs.

Maybe the 7/6.5mg was only just enough, and you would have had issues anyway irrespective of whatever extra activity you might have done.

Hopefully the extra dose will sort it out, but when you drop back down, I would stay at that dose fir a couple of weeks just to make sure before you restart DSNS.

You are around the dude where adrenals need to start thinking about working and that can make reducing a bit more difficult for some people.

[oscarandchloe in reply to DorsetLady]

Thanks, Dorset Lady, I shall up the pred for a couple of days and see if that helps. I haven't had a flare up to this point so not sure of the signs. Also have an ongoing problem with tightness in my piriformis on right side even when left side is perfectly clear of stiffness so it makes it hard to work out what's happening.

[DorsetLady PMRGCAuk volunteer in reply to oscarandchloe]

Have a look at this post then - healthunlocked.com/pmrgcauk...

[PMRpro Ambassador]

Exercise stiffness in PMR tends to take longer than usual to appear and persist longer once it starts. When that happens to me (with monotonous regularity and not due to exercise though possibly lifting something I shouldn't have) I take 800mg ibuprofen as a flooding dose and sit with a hot water bottle over the painful area. It may take a few hours and I know this weather isn't ideal for it - but sometimes needs must!!!

[jayemmemm in reply to PMRpro]

Your flooding dose sounds ideal for me at the moment, on 7mg about to start drop to 6.5mg pred. But I am extremely allergic to ibuprofen. Would paracetamol or solpadol or co-codamol achieve the same result?I like the image of you and a hot water bottle in the current heatwave. I fill mine with iced water! Best wishes.

[MrsNails in reply to jayemmemm]

You must never exceed the dose of Paracetamol Based Products as they can be extremely damaging to your liver & don’t work in the same way as anti inflammatory medications.

Anti-inflammatory Medications NSAID’s (eg Ibuprofen etc) are not generally recommended when taking Prednisolone due to the risk to your stomach, they can be prescribed & should be taken under Medical Supervision Only.

If you are experiencing PMR Pain then perhaps it’s not the time to reduce your prednisolone but stay at your current dose for a bit longer.

Kind Regards

MrsN

[jayemmemm in reply to MrsNails]

Many thanks - sound advice which I shall follow.

[PMRpro Ambassador in reply to jayemmemm]

Nothing else works for me - paracetamol is a total waste of space and liver function Even for a headache.

It probably needs to be an NSAID - you do need some antiinflammatory effect but you could try the max dose of anything - and with paracetamol you really must be VERY careful with that. I can't take cocodamol - on the other hand, it works well for my husband where paracetamol alone doesn't.

But as MrsN says - not ideal to reduce if you have back pain problems.

[Hidden in reply to PMRpro]

Likewise be very cautious with using Nsaids (ibuprofen) if you have CAD (coronary artery disease) as well.

[PMRpro Ambassador in reply to Hidden]

Even if you haven't - they can contribute to it developing

[jayemmemm in reply to PMRpro]

Many thanks, I'll proceed very cautiously