By how should I increase my prednisone?

[Buenavista]

Hi All,I have had PMR since 2011 when diagnosed. I had got down to 5mg of pred and was on this dosage for many years until I had a massive flare at the beginning of 2023 and I increased my dosage, then gradually came down to 8 and 3/4mg. I am a 72 year old fit male.

I have been going to my physiotherapist for shoulder, back and arm pain. Slowly getting back to normal until I had my flu and covid vacations. Not feeling great and aching everywhere, we put it done to side effects from the jabs. (Had to stop going to the physio until I know the cause) 2 and a half weeks later, still feeling bad with the aches and pains. Saw my doctor today and she said my blood tests came back normal and I shouldn't still be suffering from the side effects. She said it could have set off a flare.

I'm relatively fine when I'm working and keeping active, but as soon as I sit down, the aches and pains come back.

I'm on 8 and 3/4mg of pred at the moment. What should I go up to and how long should I stay on a higher dose?

Many thanks,

Buenavista

[DorsetLady PMRGCAuk volunteer]

This link contains usual advice for a flare - and suggest you drop back down to 9mg - stay there a month before resuming taper -

healthunlocked.com/pmrgcauk...

[Buenavista in reply to DorsetLady]

Thank you for the link, it is very helpful.

[PMRpro Ambassador]

I agree with what DL suggests - the basic approach to a flare if it is due to overshooting the dose. This may not be due to that so you will have to play it by ear - especially on what dose is enough in the second stage so be very sure that 9mg is enough and possibly stay there a couple of months just in case.

[AtopicGuy]

Is your "shoulder, back and arm pain" on both sides (ie. bilateral)? If so, it is more likely to be caused by PMR and less likely due to injury. You say you are "fit", and that is good, but too much of a good thing (including physiotherapy) won't help an autoimmune disease like PMR.

[Buenavista]

Hi,Thanks for your replies.

Whilst working on our cortijo and trimming up the olive trees. I damaged the tendon in my left shoulder and down to my left elbow. Hence the reason I was going to the physio and he also worked on my back as I have a trapped nerve in my spine. And so at that time, it had nothing to do with PMR at all.

I then had a flu and Covid vaccination, one in each arm. Then, as I said before, had many aches and pains for the next 2 and a half week, which we thought was side effects of the vaccinations. But the doctor said I shouldn't be getting side effects for that period of time and it was probably a PMR flare.

I was on my way down, back to 5mg from my previous flare, I was down to 8 3/4mg. But today I have gone up to 20mg to see if I can get back to some normality.

Hope that makes better sense than my previous post.

Regards,

Buenavista

[DorsetLady PMRGCAuk volunteer in reply to Buenavista]

today I have gone up to 20mg to see if I can get back to some normality.

Well that high should certainly sort it out…. 😳

[PMRpro Ambassador in reply to DorsetLady]

Certainly should!!!!