What is an acceptable level of discomfort when ta... - PMRGCAuk

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What is an acceptable level of discomfort when tapering?

Billiebobdog profile image
9 Replies

Yesterday was my first reduction in prednisolone, 15mg down to 12.5mg. My day was normal and fine, this morning I have woken with a slight increase in discomfort through the shoulders, lower back and arm, nothing extraordinary but just a change. I will go with it as I can cope with it, although annoying, but I was wondering what is ‘normal’ while tapering.

My plan is to stay at this dose for 3weeks - 4 weeks which was how long I stayed on the previous dose

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Billiebobdog
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9 Replies
CRYSTAL11 profile image
CRYSTAL11

Take it slowly. Changing quickly is so difficult. I would take 15mg one day and 12.5 the next for the first week. It helps to smooth out the process

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Would say that’s steroid withdrawal (SW) - see this post - and if it is it should go within a few days - healthunlocked.com/pmrgcauk...

But you should be aware that although 15-12.5mg is a recognised taper from the guidelines it doesn't suit everyone….sometimes it’s too big a step.

Provided it is just SW, I would suggest next taper you take a smaller drop - say 1mg or if you have 2.5mg tablets halve them to give 1.25mg - much nearer the ‘no more than 10% reduction of current dose’ recommendation.

Billiebobdog profile image
Billiebobdog in reply to DorsetLady

Thank you

herdysheep profile image
herdysheep

Hello and welcome

Others will be along soon, but I would sit it out a few days to see if it is reaction to the taper. Keep a note of how you feel to help you recognise any pattern in the future. If your discomfort increases, it could be that you are not ready for a taper if the the main inflammation is not under control, so then it would be back up for a while. I found it took some time to recognise what the different feelings meant, and after all this time still don't always get it right! Pmr is a perfect example of the body doing it's own thing and often not in sync with the brain.

Lots of help available on here and don't forget the FAQ's!

SnazzyD profile image
SnazzyD

I used to become a tired achey heap with a headache starting anywhere from day 1 to 4. Usually done from a couple of days or a week if it was a bad one.

PMRpro profile image
PMRproAmbassador

I would say that if the discomfort increases it is a sign you aren't ready for 12.5mg just yet - and I would go back to 15mg and reduce by 1mg at a time in future. Pain that starts quickly is more likely to be steroid withdrawal and it will improve over a week or two. Too low a dose will get worse over the time. In time you will learn to recognise what is what - but the easiest differentiator is to reduce in smaller steps.

Billiebobdog profile image
Billiebobdog in reply to PMRpro

I woke up with a slight increase in discomfort which has mostly disappeared now as the day has progressed- it’s also a case of working out what is a normal discomfort as opposed to the PMR 🤪

PMRpro profile image
PMRproAmbassador in reply to Billiebobdog

In that case, keep an eye on it- if it stays the same or improves, fine, if it gets worse, not so fine!

piglette profile image
piglette

Steroid withdrawal can happen in the first day or two. If you have problems in a week or so it means you may have dropped too far and you could get a flare. .

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