Steroid increase?

[Suzan62]

Hi there, I’ve been on steroids now for 4-5 years for PMR. I managed to gradually get down to 5mg successfully and then very slowly decreased from there down to 1.5. That was too low so I went back up to 2.5 and stayed there for quite a while. For the last few months the aches have slowly increased and so I’ve gone back up to 3.5 and then 4mg. Unfortunately this still isn’t controlling the aches that I get in the side of my thighs when I walk and I’m wondering if I go up to 5 is that going to be enough or am I just going to have to keep going up and up! I’m not really sure what to do for the best. Any tips?

[DorsetLady PMRGCAuk volunteer]

There are 2 ways - creeping up like you are hoping to find the right dose,

or treating it as a flare as described in this post by taking a higher dose for a short time to get a grip of the built up inflammation before going back down to just ABOVE the dose that gave you issues -

healthunlocked.com/pmrgcauk...

Obviously use the example but with your own doses.

Second option would be my choice, as the first doesn’t seem to working for you.

[Suzan62 in reply to DorsetLady]

Thank you, I do appreciate that. So the fact that I was on 2.5 which was ok for a while before I had to increase, is 2.5 the dose I go back down just above to? Also do I go up 5mg from 2.5 or from 4 which I’m on now? Sorry I just want to know I’m doing it right.

[DorsetLady PMRGCAuk volunteer in reply to Suzan62]

Might be worth trying PMRpro suggestion first. But if that doesn’t work, I would add 5mg to 2.5mg and then back down to 3mg .

[Suzan62 in reply to DorsetLady]

Thank you, yes I’ll do that.

[PMRpro Ambassador]

If the pain is on the inside of your thighs it might be worth looking for some physio exercises to strengthen/stretch the adductor muscles - but it would also be a good idea to ask your GP for advice. If the pain is on the outside of the thigh it may be trochanteric bursitis which is common along with PMR.

myrehabconnection.com/adduc...

[Suzan62 in reply to PMRpro]

Hi there, the pain is on the outside of my thighs and exactly the same pain as I’ve had before. It does just feel like normal pmr pain.

[PMRpro Ambassador in reply to Suzan62]

OK - but it could well be the trochanteric bursitis I mentioned which is commonly part of PMR. It will respond to high doses of pred - but more targeted treatment often means you get away with a lower dose of oral pred. Rest and icing will often calm it down but sometimes a local steroid injection works better than oral pred.

[Suzan62 in reply to PMRpro]

Oh right ok, I’ll take a look at those. Thank you.

[nuigini in reply to Suzan62]

FYI, I developed horrific outside hip pain a while back, I think I was on 10 mg of prednisone at the time. It felt like spikes were being driven into my hips when walking. Doc said arthritis and to walk it off. No way!! Based on my own research I realized it could be trochanteric bursitis. I followed the recommended treatment of rest, ice, and anti-inflammatory medication (Tylenol in my case) and things improved within days. I then looked up exercises and was fine a short time later.