Tapering

[Uglow]

When tapering and I’m going slow 13 to 12.3/4 does any pain return and does it settle so you know you are doing it ok. I mean is there an adjustment period for pain to settle again before you move on to next taper. Couldn’t find a link so sorry if there is one. I can never search and find what I’m looking for. Thank you

[SheffieldJane]

In my experience it can sometimes take a day or two to settle. I don’t think the search facility is that great tbh.

[DorsetLady PMRGCAuk volunteer]

Do you mean within first few days of a slow tapering plan or first few days on new dose? if so, probably steroid withdrawal. If it lasts longer than 5-7 days then probably too low... but you have to give body time to adjust to new lower dose, and everyone is different...

[Sharitone]

I'm at the same level as you, and also have some pain. Until told otherwise, I'm working on the principle that if the pain is not getting any worse, then it should be ok to reduce very slowly. After all, it's complicated by other aches and pains that sneak in as a result of fatigue and weakened muscles.

[PMRpro Ambassador]

Just going 1/4mg at a time at this level you shouldn't have too much of a problem - but if any pain or discomfort stays stable or improves over about a week it's OK. Anything that gets worse is a warning.

[cranberryt]

Yes it can take a few days to settle. I do an every other day plan to help mitigate that.

[Uglow in reply to cranberryt]

Pray tell xx

[cranberryt in reply to Uglow]

1/2 mg lower one day, regular dose the next. so if I have some withdrawal pain, it’s followed by a good day.

[Uglow in reply to cranberryt]

I’ll do that cheers

[PMRpro Ambassador in reply to Uglow]

Have you not seen the large numbers of discussions about the slowed tapering approaches? Alternate days of old and new doses are about half way through them - so they are even more gentle.

[piglette]

I find if I use the DSNS system I do not have pain in reducing.

[Offsideinzaghi in reply to piglette]

What is the DSNS system for tapering?

[DorsetLady PMRGCAuk volunteer in reply to Offsideinzaghi]

This - healthunlocked.com/pmrgcauk...

[Pixix]

When I went down 1mg each month at a time (through that amount of pred), I would get pain for 5-7 days, but it wasn’t too bad, & I found that from then on my body accepted the new dose & was fine. I chose to go that route, but not the best solution. But we are all different, & the way our body’s react is individual. Plus you are only going down by a quarter of a mg. To be honest, you seem to switch about & change your plan, & times you take your pred often, taking anything suggested (suggestions are great, but what works for one may not work for all), & I would think your poor body doesn’t know if it’s coming or going, wouldn’t you agree? The ‘gold standard’, I think, is the DSNS. Have you tried following that plan, please, & why didn’t it work for you?

[Uglow in reply to Pixix]

I have only changed time twice to see how I am. And also I’m now trying to find what works for me. I have a plan cyst I’m going to try.

[Pixix in reply to Uglow]

Um…I didn’t mention changing time, I don’t think. If I did, it was a mistake! Sorry. I meant changing your tapering plan, as you were going to try something else…but I find it takes time & patience to see if one type of taper is working before trying something different, that’s all. Good luck with your plan.

[Boss302Fan]

What tapering methodology are you following? When I was on the N.I.C.E. approach (and significantly greater drops in dose) 24-48 hrs after decrease I felt woozy and attributed to sudden decrease in cortisol. It was on day 4 after decrease is when I’d have a flare if the new dose was inadequate.

After switching to DL’s 5-7 wk Simple Taper I no longer got the woozy feeling and if I was going to flare it usually happened on day 5 of week 3.

I now know exactly when the pain I get is due to PMR or something else. If not sure I take 800mg Ibuprofen if the pain goes away or is reduced then it’s not due to PMR.

Lastly, if I have pain and it’s attributed to PMR, I don’t keep decreasing, in fact I go back to a higher dose, then reduce to where I had no pain before, stay there a week and then try again a week later with a smaller dose reduction. I didn’t start using 0.25mg drops until was at 3 mg/d and stayed with a 5 week schedule. This Sunday I’ll start week 5 of my attempt to taper to 1.75mg. Week 5 is taking the target new dose for 7 days. No pain, I’ll restart with week 1 and new dose target of 1.5mg.