Question about reducing Pred

[Purplegloss]

The last six weeks I have been reducing very slowly by .5mg from 4mg to 3.5mg. I have done this a few times without success ending in a flare. This time I am at the moment totally free in the upper half of my body from pain or stiffness, but have been getting what I think is withdrawal symptoms around the buttocks, small of my back area, which makes me walk a bit like a robot. I have been using Panadol painkillers, sometimes two a day, and sometimes four a day, which makes it easier, and so I don't think this is a flare this time, what does everyone think please? Is it just my muscles complaining at the lower dose of Pred?

[PMRpro Ambassador]

It is your body telling you that, for the moment, you have arrived at the destination: the lowest effective dose that gives the same result as the starting dose did. You will get lower, just not yet.

The low back discomfort sounds muscular - have you done anything recently that might make your back protest? Lifting, twisting? I ended up with a back problem just from overbalancing slightly as I got in the car and more falling into the driver's seat than sitting down on it!

[SnazzyD]

When you were last pain free? What are you doing in your day?

Looking at it logically assuming NO abusive force is happening to your lower back/pelvis (decorating, gardening etc) I’d say it is not just withdrawal. So, you are having to take quite a bit of paracetamol to get through, which to my mind doesn’t really count as it working in the ‘Paracetamol test’. Walking ‘like a robot’, hmm. Paracetamol works by affecting the pain centre in the brain, so it will have some effect even if it is limited and what you need is an anti inflammatory. It sounds like there is some inflammation but as to whether the driver is PMR I’ll leave that up to people who know better.

Withdrawal or low adrenal symptoms at low doses for me felt like overall pain like a fluey thing and not hot spots that hurt like hell. It may be you need a physical exam to see if you’ve done something to your lower back or it’s from within.

[Purplegloss in reply to SnazzyD]

Thank you both for your replies. Today it does seem to be getting slightly better, and I am moving around more easily. Haven't done anything to cause it as far as I am aware, and think it is just my muscles complaining at getting less Pred. I have completed the six weeks and now on 3.5mg where I plan to stay for a while. Next reduction at a later date, I plan to go for .25mg, so half a 2.5mg plus 2- 1mg to see if that is successful. Onwards and downwards at some point hopefully! Got my next Covid jab on Tuesday, but I am usually ok with that.