Can anyone explain to me what the PURPOSE of taking prednisone is, as you understand it?

[emmamom]

Can anyone explain to me what the PURPOSE of taking prednisone is, as you understand it? Is it to “cure” PMR (stop the processes that cause it) or to eliminate pain? I wonder about this because it affects how much I try to get off the prednisone. If it is to “cure” it, we obviously don’t want to rush. If it is to eliminate pain, I want to be on as low of a dose as possible, even with some (tolerable) pain. TYA

[Nextoneplease]

Well, I’m not a scientist……but my understanding is that the reason for taking prednisolone is to reduce the inflammation caused by the disease process, and thus to help control the resulting pain. So no, it doesn’t “cure” PMR, it manages it so that it’s tolerable (until hopefully it burns itself out and goes into remission 🤞).

On the other hand, if you allow the inflammation to continue unchecked, it is likely to get worse and/or to damage the muscles it affects. Also the reduced mobility caused by pain leads to muscle wastage and even increased frailty. So in that sense, taking prednisone to reduce inflammation is not a “cure”, but it is much more than a painkiller!

Hope I’ve got this right and that it makes sense.

All the best

Nextoneplease x

[emmamom in reply to Nextoneplease]

This is so helpful. Thank you.

[SnazzyD]

Hello there, it reduces inflammation and a happy by product of that is reduction in pain and increase in function. Yes, it isn’t a cure and doesn’t appear to change the disease process whereby your immune system has identified certain bits of your vascular system as the enemy and is attacking it. So toughing out the pain doesn’t do you any favours because it means inflammation is being left unchecked. The risk of that is you suffer the consequences of reduced activity. It also may be you go on to develop GCA or large vessel vasculitis which demand much higher doses to avoid serious consequences. You need to reduce to find the lowest dose that controls your level of inflammation/pain at a rate that doesn’t outpace the hopefully reducing autoimmune activity. This can take years so patience is the essential lesson to learn.

[emmamom in reply to SnazzyD]

Thank you. This is very helpful and exactly what I needed to understand.

[PMRpro Ambassador]

I'm pretty sure there is an article in the FAQs about it.

Pred cures nothing - it is a management strategy to mop up the inflammation that is created each morning by the release of inflammatory substances in the body. It is the inflammation and resultant swelling that leads to the symptoms we call PMR. PMR isn't really the disease - that is an underlying autoimmune disorder that means the immune system is unable to recognise the body as self and attacks it as if it is foreign.

[emmamom]

Thank you so much. This helps a lot.

[piglette]

At the moment Nothing cures PMR sadly, however it has been found that the wonder drug steroids relieve the pain by reducing the inflammation. Although nothing else has much affect.

[cycli]

eammamom I know where you re coming from. None of us want pred. but if you don't suppress the inflammation you risk worse. Those of us who struggled for years WITH the symptoms now have a harder ride. Pain thresholds are different in each of us but when it is at its worst there's no hope. Get the inflammation right down and then work out what to do with your body as you reduce the dose. We each have different responses and capabilities and have to adapt to what we are capable of doing. Everyone here knows this and can help. Pred. is the only practical answer at present so we live with it and try to manage as best we can.

[Call_Me_Wally]

Just to add what everyone has already said.

"In about half of people who get Polymyalgia Rheumatica, it’s a self-limited disease, which means it goes away by itself after a few months to a couple of years. In others, Polymyalgia Rheumatica can be more chronic (long-term) and can linger for much longer".

rheuminfo.com/diseases/poly...

Someone might have PMR, not know it, and it goes into remission before any treatment is started. PMR doesn't really 'it goes away by itself', it really "goes into remission", meaning there is no cure - you will always have it (it just won't be active).

The other part to this is using Prednisone (as treatment for managing pain and stiffness from the inflammation caused by PMR). You said "try to get off the prednisone".

After using it for 2-3 weeks, your Adrenal Glands will probably stop producing a quantity of Cortisol naturally because your body sees it has enough Cortisol already by way of taking Prednisone (negative feedback within HPA Axis).

Your PMR may already be in remission, but you're still taking Prednisone. You won't know it's in remission until you're done tapering off Prednisone (only safe way to know). You can't just stop taking Prednisone because you feel better and might think PMR has gone into remission. Since there's been some inactivity with your adrenal glands, you need to taper off Prednisone slowly to give them a chance to become fully active again, and this will take time (and patience). Depending on a number of things, if you did stop taking Prednisone suddenly, you could risk going into an Adrenal Crisis, which could end up being fatal. Or, you may find your PMR isn't in remission and need to figure out what dose of Prednisone to start at again.