Overshot I think!

[Queenie1901]

I was doing well with the DSNS taper from 4 to 3.5mg at the end of the year (Nov/Dec), even stopping at one point then re-starting when I was not sure of a few niggles. Read a lot on here about Myofascial Pain Syndrome which seemed to fit with my stiff neck, predominantly on the left side which started in Nov after a few days of tension when I know I was holding my neck too tight. Other odd niggles in the rib cage in my back disappeared with paracetamol and I no longer seem to have them now. I sat at 3.5mg all over Christmas to wait out the stressful season and a 3 day visit from son and young family. Still at 3 5 mg but I now have a creeping awareness that general aches are re-appearing and I have had some increased stiffness in bed at night including my neck (left side dominant) over the past week. During the day the aches have been relieved with one paracetamol, all but that neck which is only mildly noticeable until I turn my head left or right then it is not so pleasant! Seems to be the muscle than runs up the side of the neck to the base of the skull. Reviewing all these factors and desperate to avoid a possible flare I have taken an additional 5mg this morning to see what effect that has. I guess a few days at that then and drop back to 4 and not 3.5mg? I was going to have a neck massage but my therapist tested positive for Covid so that's delayed! Not to mention the delayed effect of 3 days of lively grandchildren in the house! Apart from that not feeling unduly exhausted or unwell....just the normal tiredness that I have come to live with.

[PMRpro Ambassador]

Sternocleidomastoid problems - have a google. It will respond better to targeted management, stretches, heat etc. And I'd go back to 4mg - these are low doses, no hurry. Especially if something interferes and sends you into a flare.

medicalnewstoday.com/articl...

physio-pedia.com/Sternoclei...

infusedcrossfit.com.au/top-...

Might be something useful there - warmth, there are good options for draping around the neck including long hot water bottles if you are low tech and electric heating drapes if you are a gadget person

[Queenie1901 in reply to PMRpro]

Oh my goodness....reading those articles is like reading my case notes! 🤣 And the fullness in the ear problem on the same side I realise I have had too but never connected. Thank you for the links to such comprehensive information plus practical suggestions about stretching etc. I'm on the case now! (I assume 3 to 5 days minimum on thec additional 5mg to ensure it is effective? )

[PMRpro Ambassador in reply to Queenie1901]

I'd be surprised if the pred makes a great difference to sternocleidomastoid tightness - but it might, Up to a week is the usual suggestion for a 5mg boost for a flare.

[Queenie1901 in reply to PMRpro]

Thank you. Having read your links the information seems to connect a lot of the niggles I have recently been experiencing but could not relate to my original PMR symptoms. Nevertheless, ever vigilant for a flare.

[PMRpro Ambassador in reply to Queenie1901]

Ignore them and they could build up to a flare - and they are sort of related in that they do often go together

[Queenie1901 in reply to PMRpro]

Thank you for this information. I am continuing with the additional 5mg as planned so hopefully will prevent that.

[Jontie]

Hi FlorrieYour description fits mine to a tee. My neck pain started before Christmas. I tried boosting from 3.5 to 5, which didn't make a difference. Then I boosted to 20 for a week. That put my cpr back to normal but the neck pain persisted. I've been back on 3.5 for a couple of months now. Like you, the neck is worse and I'm starting to get other niggles. So I think I'll try a 5mg boost again. Just wondered how things worked out for you?

[Queenie1901 in reply to Jontie]

Hi Jontie. I did a more recent post last week with 2 updates headed "Shall I or Shan't I" as things had built up very gradually on 3.5mg/3mg. There you can see I did the 5mg boost for 8 days after general thoughts on here, from those with knowledge and experience, suggested to do it for 7 to 10 days. On day 9 dropped back to 5mg and am going to stay there for a good monrh to make sure it is ok and inflammation doesn't get hold again. This is my third day at 5mg and so far I've been ok but too early to tell for sure. My GP also advised a month at 5mg then a slow taper at only 0.5mg per month. I will use the DSNS method when I feel ready. As far as my neck is concerned (as mentioned above) for which PMRPro gave me information and the link, heat pads and exercises certainly helped.

[Jontie in reply to Queenie1901]

Glad it seems to be working out for you. Thanks for the update.

[Queenie1901 in reply to Jontie]

Just added a bit more to my reply

[PMRpro Ambassador in reply to Jontie]

If there is a persistent neck problem it is far more likely to be a localised muscle problem - sternocleidomastoid muscle spasm is very common, the stiffness and pain running down the side of the neck from behind the ear to the collarbone. Or your shoulder muscles being tight and affecting the neck. Exercises and maybe therapeutic massage/physiotherapy often makes a great difference.

[Jontie in reply to PMRpro]

Thanks pmrpro. Yes, you've suggested this to me before I think. I have booked both a physio appointment and a myofascial massage, but the earliest I could get is mid July! Maybe I'll try and hold off increasing the pred until I've given these a try. After all, a large dose of pred was unsuccessful last time!