⁹Suspect 1mg was too low, next step?

[Queenie1901]

Using DSNS method to taper. Reached 1mg and stayed there for 4 weeks. Added another 2 weeks as not sure about few niggles. Then realised there had been a gradual increase in general aches/ stiffness over-the 6 weeks on 1mg, plus in hand and wrist joints It was so gradual I had put it down to increase in walking and exercise I was doing. Finally decided to face facts! Added 5mg for 7 days so total 6mg per day. All niggles gone. Then dropped to 4mg per day for 4 days. All fine. Then dropped to 2mg per day two days ago. Day 1 OK, day 2 stiff neck appeared on waking but much more noticeable on left hand side of neck.. One paracetamol reduced it about 90%. Day 3 today, still there, both sides but more on left side. However, so far none of the hand and wrist joint aches have re-appeared. So now I am confused. I had no stiff neck before I upped the dose by 5mg but now I have reduced again it has kicked in. Is this just a reaction to the dose lowering in steps as it is so immediate after the drop from 4mg to 2mg? Not sure how to view this or how to proceed now!

[Queenie1901]

Eureka! By writing this down I re-thought the last few days and might just have answered my own question. On day 2 of the 4mg I tripped over a trailing seat throw and fell rather heavily on my knee and also against the wall with my upper arm and shoulder. Added ice pack to knee but ignored the rest. Greater damage was to my pride! Perhaps I jarred the upper arm and neck and this only came out after 3 days and the drop to 2mg???? So perhaps just continue at 2mg and see how it goes?

[PMRpro Ambassador in reply to Queenie1901]

I was just about to ask if you had done anything, however minor - and that wasn't minor!!!! When you fall or even just trip over something, it wrenches all your back muscles as they try to save you from falling and keep your balance. And then they protest as they settle down again. One mg wasn't quite enough overall, that seems quite apparent - but the other bits are due to the fall and a separate item. Heat might do the job - and perhaps some topical muscle pain cream. And just general TLC - with not too much reduction before Christmas!

[Queenie1901 in reply to PMRpro]

Thank you for clarifying the "fall out" from the injury. Apart from the knee I had discounted the rest! Rather naive on my part!

[PMRpro Ambassador in reply to Queenie1901]

Nah - it's all joined up!!!

[Koalajane in reply to Queenie1901]

Blimey that has explained something to me too. I couldn’t understand why my back was hurting about 4 days after I tripped over the kerb. I had fallen on my knees and they were sore and not realised that I had probably jarred my back in stopping my head from hitting the pavement. Now I understand.

Hope you feel better soon

[PMRpro Ambassador in reply to Koalajane]

I was once standing on a bus when it stopped suddenly - two days later I could barely move. I hadn't even fallen, it was just the jolt! Even a mild whiplash from braking suddenly can do much the same.

[DorsetLady PMRGCAuk volunteer]

If paracetamol helped by 90% then doubt it is all down to your PMR, and sounds more like a combination of that, steroid withdrawal and/or injury.

But it might have been better if you’d stayed on the increase for a bit longer even though you felt okay at day 7, but that’s by the by, it’s done now…

As you say you have been more active, are you sure the neck is not related to that and coincided with other things…

EDIT -Ah ha…just seen your second response-so will amend

I think I’d be inclined to try 3mg … and maybe stay there 7 days, but you can be there for 14 days in total without impacting on subsequent reduction. You should be able to then drop back to 2mg or 1.5mg… but not to 1mg, that might just be on the cusp of enough/not quite enough/definitely not enough Pred…

[Queenie1901 in reply to DorsetLady]

Thank you for your very comrehensive reply. I had been wondering about 3mg but was not sure if on the back of the other increases it was too long a time frame. I see now that it will be OK. Plus food for thought about activity that might have impacted this as well!

[DorsetLady PMRGCAuk volunteer in reply to Queenie1901]

..and no rush to reduce over Christmas time …,