night aches

[Loveopera]

I have been tapering very gently down from 5mg prednisolone and am now at 2.5 after sn intial 15mg in June 2020. So generally pleased with myself. However i appear to be being hit on occasions with oretty severe night time aches which seems to effect everything, joints, muscles even to my wrists. I dont want to take anything other than paracetamol as stomach likley to be empty and its not that effective..

Is this possibly that cortisol levels not high enough yet and will eventually return or is it just arthritis ill have to learn to put up with?

Might it be worth changing my dose from morning to evening ?

Any help Id be grateful for - bad night last night after a very special day of our daughters wedding so im a bit cross!!

[PMRpro Ambassador]

What time do these aches appear? At what dose did they appear?

[piglette]

It does not sound particularly like adrenals. They tend to cause intense fatigue and more a fluey feel and make you feel miserable.

[DorsetLady PMRGCAuk volunteer]

Well last night’s issues might may have been as a result of what went on during the day… in that you did too much.

But if paracetamol isn’t helping you may have got to the stage where current dose of Pred isn’t enough.

[PMRnewbie2017]

At 2.5mg please don't switch to night time dosing. That will mess up the midnight nadir where your cortisol level needs to be at its lowest to trigger natural cortisol production. You need to take it easy from now on. As lovely as the wedding was you may be experiencing the effects of insufficient cortisol. Both Pred withdrawal and AI can cause muscle pain and weakness. Try taking some painkillers with your evening meal and at bedtime to raise the blood levels. One off doses at Otc (over the counter) levels won't do much for arthritis or myofacial pain.

[Sunnyday365]

I have a similar experience while I am tapering to 2.5 , late at night I start to feel twinges in the same areas the pain originally started. Not sure if I should go back to 3 or keep finishing taper.

[DorsetLady PMRGCAuk volunteer in reply to Sunnyday365]

I’d be inclined to return to 3mg -if you continue tapering and it’s the beginning of a flare it will only get worse. So don’t give it the chance.