Tapering to the Razor's Edge ???

[MikeVanBC]

Hello Folks,

Several days ago I awoke with a mild morning ache across my shoulders. Since then, when climbing stairs my legs feel as though they're recovering from a massive workout.

This condition surfaced one week after I tapered from from 5.5 to 5mg of prednisone. I've continued with 5mg of pred and the symptoms have remained the same for the last 5 days, not getting any better, but no worse either.

Is there any merit to staying here in the hope things may improve, or am I better off jumping to 10mg for a few days to clear any residual inflammation, then go back to 5.5 or 6mg?

I would like to get to or below 5mg in the hope it may at least partly awaken my adrenal glands, but unless these symptoms are related to adrenals or pred withdrawals, is it reasonable to assume that I'm riding the razor's edge of keeping PMR under control at 5mg?

If there are any possible benefits of enduring this mild discomfort, I'd very much like to hear them. Certainly quality of life is better without morning shoulder pain or all-day leg fatigue. But I am willing to endure some discomfort if there are some offsetting collateral benefits. However, if there are no such benefits, I'll take more pred! What do you think?

[DorsetLady PMRGCAuk volunteer]

As it’s taken a week to materialise, then it’s sounds more like a flare than steroid withdrawal, so by taking no action it’s likely to escalate….so sensible to bite the bullet and increase as you suggest.

Stay at the increased dose for at least a week…a little longer will do no harm then (personally) I’d go down to 6mg rather than 5.5mg….that may have been just, but only just, enough.

From then on I’d also be trying a slower tapering regime (if not already) - either of these -

healthunlocked.com/pmrgcauk...

healthunlocked.com/pmrgcauk...

Slower tapering will also help adrenals …….

[MikeVanBC in reply to DorsetLady]

Thanks very much DorsetLady. Do you think I should go as high as 10mg, or that something like 7 or 8mg for a week may be sufficient?

[DorsetLady PMRGCAuk volunteer in reply to MikeVanBC]

Usual advice is to add 5mg to last dose you felt okay…..so I’d plump for 10mg and for anything between 7-10mg. It needs to be high enough and long enough to work successfully….any less and you may just be wasting time and effort…..

[piglette]

Trying to tough it out is not a good idea, the PMR always wins! As it sounds like a flare I would increase by 5mg for a week or so to really knock the PMR on the head. Then drop to say 6mg for a few days to make sure things are OK.

[MikeVanBC in reply to piglette]

Much appreciated Piglette. I have had a double dose x 5mg now today, as you and DL recommend. Thanks kindly.

[GarryB63]

Ive just done exactly the same Mike. I've been riding the razors edge for 4 weeks at 5mg and hoping like you things would settle. How wrong was I! Woke at 430am with pain in all joints, as bad as ever, so dont risk it. I know from experience my GP will tell me to take 15mg for 3 days then 10mg for 2 days and then down to 7mg and start my monthly tapering again.

[MikeVanBC in reply to GarryB63]

Wow Gary! Thanks for the first-hand advice on avoiding this land mine!

[PMRpro Ambassador]

I agree with DorsetLady.

[MikeVanBC in reply to PMRpro]

Thank you very much for confirming. Much appreciated.