For the past two days, I have new PMR pains.

[RaisinBran]

I,m sorry that I am back so soon asking for additional advice. I have been on 3mg of Prednisone for the past 22 days tapering down from 15mg over the past 26 months. I am suddenly having all over body pain-legs, knees, back, and both hips. Tylenol 1000mg three times daily doesn't seem to help at all. The pain is constant and on a scale from 0-10 (10 being high level pain) it is a 6-7. I have never experienced this before while on Prednisone---Could it be a flare? Can I try raising my prednisone, to determine if that helps? What level would you suggest to try? Thank you again.

[HeronNS]

It sounds like a flare. Are the symptoms very like what you experienced before pred? How are you tapering? One mg drop overnight to the new level, or introducing the new dose slowly over a period of weeks, and preferably half a mg at a time once below 10 mg?

Has anything happened in your life, physical or psychological stress? Illness? Something like that can trigger a flare. Or just going too low when your body still needs more pred than it's now getting. Or a combination of factors.

The easiest way to check is to do a pred test. What was your dose when you last felt the symptoms were completely under control? You should go a few mg above that, standard advice is 5 mg, and see if you get good relief. If you do, you can stay at that level for a week or two and then drop back down quickly, but not all the way back to the level where you flared.

Others will be along to give more details on that procedure as I'm a bit fuzzy on the details.

[piglette]

HeronNS has given good advice. 5mg rise for a week or so to knock the PMR on the head.

[DorsetLady PMRGCAuk volunteer]

usual advice for flare contained in this link -

healthunlocked.com/pmrgcauk...

- and if that works, then when you drop back down, go to 4mg rather than 3mg. Less than 2 years into PMR and you’ve undoubtedly gone too low… so ease up on the tapering for a while.

[PMRpro Ambassador]

Have another look at my reply to your last post - you are never tapering relelntlessly to zero and the fact you have got stuck repeatedly at 3mg suggests that is your dose FOR NOW, If you go below it you will flare as the inflammation that isn't being dealt with builds up.

You have heard the flare protocol I'm sure - add 5mg to the dose where you flared for 10 days to 2 weeks and then drop back the last dose you were good at, And stop pushing to get lower. I know you want to remove pred from the equation to clarify whst you are looking at but if you need that much pred for the PMR - you need that much. Nothing will get you lower until it burns out.

[yogabonnie]

Sounds like 3mg is your place to stay for a few months at least. I understand your wish to get down and off prednisone. Most of us are just the same in that way. It took me a few flares to realize that I need to stop for a long long while at 2 mg. and stop trying to go lower. If you want to do more maybe walk more or do some strength training or swim or whatever and stay put at 3mg for 3 or 4 months .. forget the struggle for now and start again later. I get so focused on dosage and PMR and illness that I do forget to go ahead and live. The prednisone won't kill us but the lack of it will force us to sit in pain. Good Luck!! Gambatte! is what they say in Japanese. for some reason I love that word!

[RaisinBran in reply to yogabonnie]

Thank you yogabonnie!! Good info

[RaisinBran in reply to RaisinBran]

I have raised it to 8mg and feel so much better. I will try this for two weeks and drop back dow to 5mg for an extended period of time.😀