I have been on Prednisone for two and half years and have slowly reduced to 2and half mg. Now got pain in Rt hip and the outside of the thigh. Also a slight pain in right shoulder. I have had a relatively pain free reduction and have continued with yoga and kayaking. I am not sure if this pain is PMR pain being on to low dose. Hip pain is present all day and night with slight twinges in the left hip as well.
My question is do I go up on the dose and by how much or see a doctor about other possible issues.
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UmiMck
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Morning, is it possible that you have strained something on your right side whilst kayaking or even yoga. If its fairly recent I would be tempted to leave a bit longer before upping your Pred. Have you tried taking some normal OTC pain killers to see if they have any effect. If they do then it's unlikely to be PMR pains.
Thanks. Have tried Panadol Oesto for back pain. This hip issue has been going on for quite a few weeks coincided with a reduction from 2:5mg with a planned 8 week reduction to 2. I will see how I go with Panadol during the day
The one sidedness sounds like you’ve tweaked something and you’ve certainly got form there 🙂. My first stop would be with a good physio, osteopath or a GP who is good musculoskeletal issues beyond rest and pain killers. Bodies can just decide they’ve had enough sometimes even with activities you do a lot, sometimes especially because of activities you do a lot. All you need is small muscle to become strained or inflamed and it can set of a chain reaction as others become over used. Occasionally I get hip pain in bed and need to have a knee wedge for a week or two for example, particularly if my piriformis becomes tight. It can end up upsetting the whole coccyx. Look out for repetitive or one off activities where you gave something some extra oomph. Did you bump that hip or fall over? With the outside of the leg involved, perhaps trochanteric bursitis is a possibility, see this
I have been walking a lot more than usual. I am also suspecting bursitis. Been struggling a lot with fatigue and then not getting enough sleep. Have been taking Melatonin 2mg and that gets me to sleep and then wide awake 4 hours later. So I guess I am a bit of a mess at the moment. Feel so tempted to up the dose to 5mg so I could feel good and lead a normal life.
..and further to my other reply, it might be worth going up a bit….. you are only 2 & half years into PMR…. so not a great rush to reduce - and no point in not taking enough medication to be honest 🤔
As SnazzyD says you do seem to have form in regards to minor aches/pains related to your kayaking, and as we know PMR muscles do not recover as well to exercise, especially repetitive action, which presumably is part and parcel of that.
However, you maybe should consider that you are at a level where you may be teetering on the “plenty of Pred, just enough Pred and not enough Pred” scenario. You did mention about 4 months ago you had issues at the same 3-2.5mg reduction….
As has been said ad infinitum on here, you are not reducing come hell or high water to zero, you are trying to find the lowest dose at any one time that gives you same relief as original dose did…. so maybe give yourself a few months at current dose [or even back to 3mg if necessary] to really make sure it is enough before you try tapering again…..
and as many have discovered before you, half a mg really does make a big difference at such low doses….it’s not a race to reach zero.
I have been on 2.5mg for 2 months and had started a reduction to 2mg. I had sat on 3mg for 3 months. Seems such a pity to go back up to 3 mg again. Will that affect my adrenal function? At 3mg I had a quality of life.
Checked my diary and I have been on 2 .5 for 4 months and was going ok till I started to taper to 2mg. At 2.5mg I was coping ok with a few niggles. Perhaps I should stay ay 2.5 and try and sort out the hip issue. It is difficult to get correct dose cutting down a 5 mg tablet. I had no specific Adrenal issues apart from feeling tired and fatigued but still managed to lead a life at a slower pace than usual.
Been cutting 5mg tablets to reduce the number of pills I take in the morning. I take blood pressure medication, statins and blood thinner in the morning. Just very daunting taking soo many pills
I'd far rather take 3x1mg that a cut 5mg to be honest - you taste the cut tablets more! I took more than you in the morning until the antiarrythmic was changed though I did have to take some at 7,30 and that at 9,30 to separate two of the drugs. I don't mind when you can just sit there and take them all at the same time.
Shouldn’t worry too much about it….as PMRpro says 3 or 4 tablets are better than a cut one..and less faff! …and you know what you are getting every time.
A common cause of hip and outside of thigh pain is trochanteric bursitis which can be part of PMR. Is it worse when climbing stairs? Walking a lot will also irritate it. Resting from the aggravating activity and icing may help.
As DL says, melatonin may be decreadsing the effect of your pred - why not try one of the Nytol products?
If this is the second time you have stuttered at this sort of dose consider you may have reached your destination for now. When that happens it is often the body sending you a message. You are not heading relentlessly for zero, you are titrating the dose to identify the lowest effective dose that manages the daily dose of inflammation as well as the starting dose did. Pred cures nothing, it is a management strategy - and not being on quite enough is pointless as all that happens is that the left-over inflammation builds up until you have all the symptoms again, just as a dripping tap will eventually fill a bucket and overflow.
The fatigue is the low dose and your adrenal function lagging behind, If 3mg is much better then go back and stay there to let your body catch up. It doesn;t mean you won't get lower - just not yet.
just trying to understand how bursitis is part of PMR? If so then perhaps I should go to 3mg and be happy again. Will just upping the dose by .5mg fix the inflammation
!The main types of inflammation associated with PMR include:
Bursitis. PMR often causes bursitis in the shoulder, hip, and neck joints. Bursitis is the inflammation of a bursa. A normal bursa is a tiny fluid-filled sac that functions to reduce friction and ensure smooth movement between the bone and the surrounding tissues, such as muscles, ligaments, tendons, and other soft tissues adjacent to the bone. Normally, the bursa is lined by a synovial membrane and contains small amounts of fluid. In bursitis, the membrane of the sac is inflamed, and there is fluid buildup inside the sac, causing pain."
Can't say if adding 1/2mg will do it on its own - you might need to do the dealing with a flare approach of adding 5mg to your current dose for a week to clear it out. Try going to 3mg and see.
Thank you for the explanation. Makes sense. Will try the flare approach as the bursitis is quite debilitating and also feeling twinges in the shoulders.
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