should pred eliminate all pain and stiffness?

[Hephzi]

I’ve been on pred 15mg almost 3 weeks. Great improvement which I am happy about. Although I am still a bit stiff in hips and can’t lie comfortably on my side in bed. Shoulders not perfect but miles better. I’m seeing my rheumatologist tomorrow after blood tests last week. Just wondering if I should up dose or not? Just not sure my expectations are too high? Thanks.

[SheffieldJane]

You can expect at least 70% relief of symptoms. I had better relief than that ( the Pred miracle) but I needed 20 mgs as my initial dose for 6 weeks.

[piglette]

There are a few lucky people who have 100% relief, but there are also an awful lot of us who still have some aches and pains, but very much improved from before the diagnosis.

[PMRpro Ambassador]

What they look for is at least 70% improvement fairly quickly but that is overall. Some people do better than that, others take quite a while to get any better than that. I had an amazing minor miracle in 6 hours overall - my muscle stiffness was gone - but it took about 3 or 4 months for the hand and foot pain to ease and about the same for the hip pain due to bursitis which is what is causing your inability to lie comfortably on your side. Sometimes trochanteric bursitis doesn't respond that well to oral pred even though it is part of PMR since the blood supply to the bursae isn't as good as that to muscle. That is possibly something to mention to the rheumy tomorrow. He may offer an steroid injection. There are also exercises that help somewhat and avoiding too much walking and stairs above all will ease it.

myhealth.alberta.ca/Health/...

[Hephzi in reply to PMRpro]

Thanks. I’ll see what he says

[cranberryt]

I was 80% better in under 24 hours but it took 2 months before the pain was entirely gone. I still have days I can wake up achy or stiff but my dose handles it. If it didn’t I would go back up to the last dose that did keep it at bay. But there are nights I can be a bit sore in the hips or neck and usually I can associate them with having overexerted the day before. (now 4.5 years since dx, 1.5mg)

[Twopies]

I have never been pain free. After 2 months the rheumy said, “oh, you've got a bad case.” I’m stiff and sore everywhere, always have been. Not aching, but soreness. I’m defo in the 70% group.

[Boss302Fan]

I think the answer is “that depends.” Prior to being diagnosed with PMR did you experience any pain or discomfort sleeping on your side or any other position? In other words before PMR symptoms did you typically have aches and pains? I didn’t and my philosophy was if I could eliminate the discomfort or get it to less than 2 on a 1-10 pain scale that’s what “I” did. Please understand that I was at 9.5+/10 in pain at onset and the ER doctor gave me 80 mg Pred and the pain disappeared in less than a hour, thus I knew it was possible and that became my target. What I’m trying to say, and doing it poorly, is before PMR whatever was your normal level of everyday discomfort, that is what level of discomfort I would expect when I have the Pred at the dose that’s controlling the inflammation due to PMR. Another thing it proved to me was that since they gave me the 80 mg two days in a row (held me overnight for observation) on an empty stomach and had no side effects, including it didn’t kill me, I knew that at least for a short while I could handle 80 mg/d. On day 3 they put me to 60 mg/d and I was on that dose for 4 weeks. Still no issues, so, do you think I was the least bit worried about increasing my dose back up 5-10 mg if I felt discomfort for a few days? Hardly. I’m not advocating taking a large dose of Pred., but below 25-30 mg and especially around 15 mg “I” wasn’t hesitant about increasing it a few mg if necessary, especially since what side effects (2) I did encounter over time were easily negated with Rx eye drops or lowest dose of a medication. I was 64-1/2 yo when diagnosed and 67 when disease went into recession (cured?).