Almost off pred.. But….

[N-London]

After almost seven years with PMR and of this sick drug I am down to 1mg a day and about to stop. Yeh!

Yes I am not pain free but decided at the age of 66 I am going to have some aches and pains. Mostly shoulders and hands but better once I get going in the day.

The but. I have an issue with my left foot. I keep getting serious pain in the foot, bright red instep. Not gout, Uric acid test 275 well within the range.

Has anyone else has this? Is it a part of PMR?

[123-go]

I haven’t heard of your foot problem being associated with PMR but without doubt the redness is a sign of inflammation. Does anything ring a bell here?:

healthline.com/health/pain-....

Rather than Prednisolone being a ‘sick’ drug I would describe it as a ‘life saver’. Ask yourself where you would be now if you hadn’t taken it. 😏

[PMRpro Ambassador]

I agree with 123-go - pred is not a "sick drug", it has given most of us our lives back. And while you are heading the right way and maybe you ARE in remission and can get off pred, do be really aware if those aches and pains start to increase, Even 1mg can be plenty to manage low level PMR activity - but if you take it away and there is nothing to scoop a bit out of the bucket of inflammation, sooner or later the dripping tap will fill the bucket and it will overflow. Should that happen - you can easily end up back where you started. So beware.

A normal uric acid level does not rule out gout and it can often be normal during an acute attack.

hopkinsarthritis.org/arthri....

[N-London in reply to PMRpro]

Sick because Inhave been here before at zero before and yes after 7 long years it may keep it under control but the side-effects are crap.

So yes, been here before but this time I hope I can stay off them with the full knowledge it can flare.

I have had gout often and this is different its not in a joint which uric acid causes. Yesterday could not put a shoe on with a lot of pain. Today I am wearing sneakers but it's red and inflamed??

[PMRpro Ambassador in reply to N-London]

Have you stepped on it awkwardly? Could it be the dreaded fractured metatarsal?

By the time they are at 1mg most people don't have pred side effects - rather surprised if you are.

[N-London in reply to PMRpro]

Very few side effects now. But dread a flare and going back on them at silly numbers. Looking forward to having none even if just for a while. Does anyone really ever get off completely?

Foot is strange its the top of the instep nothing I can see with toes or the arch.

[DorsetLady PMRGCAuk volunteer in reply to N-London]

Very few side effects now. But dread a flare and going back on them at silly numbers

Actually in the great scheme of things, 'silly numbers' for a flare of PMR, don't really apply.. you only need an extra 5mg for less than 2 weeks...

.. but for the record, the issue with your foot doesn't sound like PMR ..

.. and yes many get off Pred completely.

[PMRpro Ambassador in reply to N-London]

If 1mg is working well - staying at it is probably the best way of reducing the risk of a flare and needing to increase the dose. Prof Dasgupta told us a few years ago that he often keeps patients on 2-3mg long term as that reduces the incidence of relapses. I think 2-3mg is high, if the patient can get to 1mg I think they could stay there permanently. I do understand the fear of a relapse - but forcing yourself off pred just for the sake of it is probably as good a way of tempting a flare as any.

Loads DO get of pred entirely, some have relapses, many don't.