Can I temporarily increase my Pred for a few days?

[Workingcocker]

I have had PMR since Jan 2021 - started on 20mg, reached 4mg 2 weeks ago, slowly tapering using the DSNS method.

For the last few days I have had shoulder pain, general joint stiffness and even less energy than normal. Pain reduces during the day.

Next week I have two consecutive days of increased physical activity. My question is can I temporarily increase my Pred to help me with this short period and if so, by how much?

Many thanks for any advice

WorkingCocker

[PMRpro Ambassador]

It actually sounds to me as if you have overshot the dose you are looking for and your PMR is no longer being fully controlled by the new dose. You aren't reducing relentlessly to zero - you are looking for the lowest effective dose, the lowest dose that manages your symptoms as well as the starting dose did. This a process called titration of the dose and you find it by tapering slowly until the symptoms start to return and then you go back to the last dose that was good.

Since the symptoms returning indicates that there is inflammation accumulated and the usual advice is to add 5mg to the dose where you flared for a week to 10 days to clear it out and then return straight back to the dose ABOVE where you flared.

That will actually cover you nicely for next week! And sort out this probable flare at the same time.

[Workingcocker in reply to PMRpro]

Many thanks for your prompt reply and sound advice. I will do as you suggest.

[DorsetLady PMRGCAuk volunteer]

You can -just so long as it doesn’t happen too often.

But it does sound as if you may be flaring anyway -and this link explains how to deal with that - and if that’s the case then next week is going to add to it if you aren’t careful-

healthunlocked.com/pmrgcauk...

However the increased fatigue may be adrenals struggling -so maybe a look at this as well -

healthunlocked.com/pmrgcauk...

[Workingcocker in reply to DorsetLady]

Thanks very much for the additional information and suggestions.