Help! Do I have to increase Pred?

[Loyd]

A few weeks ago I was so pleased with myself as I’d got down to 4 and a half mg of pred and feeling good and pain free. Started to get sore around my shoulders at 4mg and hoped it was just a bit of arthritis. Dropped to 3 and a half and it’s now it’s getting worse. My questions to all you wise ones -

Do I stay steady at 3 and a half and hope it gets better?

Do I increase the pred?

If so to what and how long for?

Really appreciate any help.🙏🙏 Hate the thought of going back up again.

Many thanks in advance. (71 year old female with PMR for 2 and a half years)

[DorsetLady PMRGCAuk volunteer]

From what you describe it does sound like a flare…especially as it has got worse as you decreased.

Have a look at this post - particularly the section on how to treat a flare….

healthunlocked.com/pmrgcauk...

You may be able to catch it with just a small increase if you’re lucky and quick enough - say 4.5 or 5mg, try that for a week or so, if it does you could probably step back down to 4mg, but no lower.

If it doesn’t work then follow example in link, adjusting to your own doses…so add the 5mg to 4.5 (or 5 if easier).

[Loyd in reply to DorsetLady]

Thank you so much Dorset Lady! That gives me something positive to work with. I’ve just taken paracetamol to check and see if that makes a difference if not I’ll go back up to 5mg for a week and see. Many many thanks. X

[cranberryt]

Staying in pain will just cause inflammation to accumulate and you will continue to feel worse. I would go back to 4.5 since that is the last dose you felt good at. Stay there for a couple weeks vefore trying 4 again. And don’t try to press forward if after a weeknor so you still have some discomfort.

[Loyd in reply to cranberryt]

Thank you Cranberry - good advice I think. I don’t want to ever have to go back up really high if I get another massive flair.

[PMRpro Ambassador]

I'd go back to 4.5mg immediately - and you MIGHT get away with it. But you had the warnings at 4mg - never ignore them, even if all you do is stay there another month.