Very stiff knees and slightly puffy ankles

[Stargiver]

I have been putting it down to overdoing it, but don’t think this is the case.

My PMR has always been in my knees and hips, not shoulder girdle. I have had it for just over 2 years and been up and down with Pred like many people. Thought I had successfully got down to 6 mg, which I have been on for about 2 weeks. Maybe it is the 7 to 6 mg drop which I have read is a bit critical for the adrenals to get through. The constant knee pain is making me feel rather decrepit and my lower back and hips ache if I do too much. Doing ‘too much’ is sounding like I have been lifting weights, but this isn’t the case. So does anyone think I ought to go back up half a mg or more and see if the pain subsides? I have high BP and the steroids make that worse so there is pressure to reduce Pred. I am on quite a lot of BP meds.

Thank you for everyone’s help.

[DorsetLady PMRGCAuk volunteer]

I’d be inclined to go back up to 7mg and see if it helps….2 weeks on new lower dose is just about the right timescale to say it’s too low.

If that doesn’t work within 4-5 days - then follow the advice in here for a flare - and then back to 7mg rather than 6mg.

healthunlocked.com/pmrgcauk...

Plus in future I’d be only reducing by 0.5mg at a time and using one of slow tapers PMRpro and I are always recommending.

But it might be worth getting hips/knee double checked for osteoarthritis or anything else - as you get lower other aches and pains have a habit of appearing…

[Stargiver in reply to DorsetLady]

I will try going back up to 7, but did reduce by a half mg for a while before going to 6. I understand the 'treating a flare' and also very slow tapering but this barrier of 7mg to 6mg seems to be a sticking point for me. I also don't want to yo-yo with these steroids, but it seems that is what is required sometimes. Just the few hours since I took 7mg this morning seems to have helped with the stiffness, so it must be that I wasn't taking enough for the 10 days I was on 6mg. Darn it - I thought I was winning!

[PMRpro Ambassador in reply to Stargiver]

It isn't "winning" or "losing". The disease activity needs a level of pred to manage the inflammation and it quite often remains steady for some considerable time. If you get stuck at a similar level repeatedly that is your body telling you that you have arrived at your destination - the lowest effective dose. For now - it doesn't mean you won't get lower, just not yet. This isn't a relentless progression to zero come what may. And trying to force a reduction usually results in trouble and may make subsequent tapers harder.

[SheffieldJane]

When I had this knee symptom with swelling I was offered a steroid injection directly into my knee by my Rheumatologist which can be helpful. I seem to get phases of it over the years. This maybe an option for you. Mine behaves like osteoarthritis. Elevate your legs when you get a chance.

[PMRpro Ambassador]

Try going back - but the puffy ankles need to be looked at. It sounds to me as if there is something going on in the lower back and that is causing the other problems. I have similar problems.

[piglette]

Have you tried painkillers as the symptoms may not be caused by PMR but something else?