See my last post.
Been tapering slowly by half mgs. Stayed on 8.5mg but have had to go back up to 9mg but this doesn't seem enough as stiffness and pains in shoulders (especially right) and hips. Do I go back to 10mg to get on top again?
Can't seem to get below this level !🤥
As I suggest in previous post maybe you need to treat it as a flare and take the action described in the link I attached last time.
As you’ve said you maybe have reached the lowest dose you can for the moment, so no point trying to bulldoze below it….. get the flare sorted, drop back down to 9mg, or maybe 10mg…and after 3-4 weeks recommence your tapering plan.
You will get below 8.5mg…but not just now! Patience, patience and more patience is required in this game!
Thanks - takes patience to have patience don't you think. What dose should I go to - 10mg ?
It does take patience -This is excerpt from my previous link - so I would say you need more than 10mg initially - see example-
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Sometimes a return to previous dose is enough, but if it’s got too bad then it’s recommended to add 5mg to the dose you last felt alright - stay there for 5-10 days and then drop back down to just above the dose you flared. Stay there for 2-4 weeks to make sure all okay before you try and taper again.
If inflammation has been allowed to build up significantly a staged reduction may be required.
Example - if you flare after dropping from 9-8 mg, but were okay at 9mg -
Go to 14mg .......get symptoms under control - then drop back to 10mg .....and continue tapering schedule.
If you’re unsure, then drop to 12mg, stay a week then drop to 10mg......
If you repeatedly struggle at a similar dose it is your body telling you that you have got to your interim destination. You are never reducing relentlessly to zero, you are looking for the lowest effective dose at the present time. You start with a dose that is more than enough and then taper the dose to find the best dose for you - a process called titration which is done with many drugs, usually from low to higher but that doesn't work well for PMR and pred.
The more you try to push to a lower level the harder subsequent reductions seem to become if you get into a yoyo situation with the dose. You need to identify the dose you get stuck at, take a bit more for a short time to manage the flare as DL has explained and then stop before the dose you flare at. If 10mg is good, 9.5mg is not, stop at 10mg for a few months and get properly controlled. Then you can try 1/2mg drop again - but stay at that dose for longer before trying the next drop. It isn't a race and when you try to force a drop you often end up needing more pred over time than if you give in when flare signs appear.
Thank u v much for your v sensible reply. V frustrating and really dont like the yo yo approach to taking pred but understand completely the tortoise approach. And don't want steroid sparing drugs for obvious side effects.Thanks again
Stiffness & Aching
Lower back pain and stiffness
Why is the pain and stiffness much worse in the morning
Pain, stiffness then nothing
increase in pain and stiffness on reducing pred
