Just been diagnosed with Polymyalgia 2 weeks ago and am on Prednisone 15mg steroid dose alongside 2 x 500mg Naproxen, 1 dose 20mg Omeprazole, 4 daily doses of 2 x 500mg paracetamol plus 2 Adcal-D Calcium/vit D tablets. The pain is manageable now - I can get some sleep and the pain/stiffness in my shoulders and neck is virtually gone (Yay!). But I am disappointed that I still have painful gluteal (buttock) muscles and stiff legs. Particularly at night and the morning. I'd like to know if others have this please and if I can hope to be painfree. I presume my dose will not be decreased in a weeks time if I still have this much pain? Do you think legs been stiff and tight and painful glutes are the Polymyalgia or if they may respond to sports Physiotherapist sessions. I'm wondering if those muscles have seized up due to the muscle issues caused by Polymyalgia rather than the condition itself. 🙂
Hello - I'm new to all this.: Just been diagnosed... - PMRGCAuk
Hello - I'm new to all this.
Hi and welcome.
What sort of improvement have you had on 15mg? 15mg is the bottom of the starting range for PMR and really it would have been better had your GP started you on 20mg and no Naproxen or paracetamol since NSAIDs really do not do anything for PMR and they are discouraged in the 2015 Recommendations for the management of PMR and paracetamol does even less in most people's experience. The correct dose of pred is far more important.
ard.bmj.com/content/74/10/1799
DorsetLady will be along soon and give you her introductory post with lots of information and so will lots of others. I'm a bit pushed for time just now - but you will hear plenty from me another time.
Thank you that's really useful to know. I did get a huge improvement in that all the extreme pain/stiffness in my shoulders, collar bones (whole décolletage area above chest below neck) and neck area. Now I can raise my arms, comb hair, take a top off normally - none of which I could do before the Prednisolone. My Gluteal and leg muscles pain/stiffness is much better too. The lovely Dorset lady has got in touch with a wealth of help and information. She also said the same. Thank you.
Hi, and welcome
Did message you, but will repeat here for completeness -
Good to hear you have some relief, but you shouldn’t really require paracetamol and naproxen as well as pred for your PMR . Unless they are for other issues - are they?
It does sound that the 15mg may not be quite enough, or you haven’t been on it long enough or you have fallen into the trap that many do thinking that just before you are on Pred the PMR is cured. It’s not, it’s just being managed.
Maybe have a look at this link for more info -
healthunlocked.com/pmrgcauk...
.. and I’d steer clear of physio for time being - and you do need to tell GP you are still in pain…or they will expect you to reduce.
Hello. Goodness they have gone all out on the pain killers. If your pain is due to PMR, the Naproxen and Paracetamol won’t be much help. Although Naproxen, a non-steroidal anti inflammatory, is also an anti inflammatory the condition requires a strong broad spectrum anti inflammatory like Pred. In fact non-steroidals like that are contraindicated with Pred. I would myself not be happy taking a gram a day of Paracetamol for my liver’s sake, especially as it is useless with PMR.
You may still be in pain because the dose it too low to start with. Some people need more and the starting range is up to 25mg for PMR. Another reason may be because you have done a bit more activity than you can tolerate right now. Some people get back to life with gusto because of blessed relief of pain, though are not 100%.
The timing fits with the natural release in inflammatory substances at night which is why PMR sufferers find mornings a challenge. One thing to remember is that Pred only deals with the inflammation and therefore pain and not the autoimmune activity itself which plays to its own tune while you wait. Pred is a safety net and symptom reliever and will only work if it is at a dose level that matches the intensity of your autoimmune activity. Sounds like you need more not less Pred.
Thank you. I have a follow up phone appointment with the GP on Tuesday so can discuss with her going up on dose if I'm not pain free by then. Though I am still holding out hope that the current pred dose may miraculously give further improvement before then.In the meantime I have for the last 2 nights stopped the evening Naproxen. So good to understand why Naproxen doesn't usually help. Thank you.
I forgot to say that drugs like Naproxen only hit the production of one type of inflammation substance. Since there is more than one, this is what meant by a broad spectrum anti inflammatory like Pred which covers other pathways.
Thank you. That's really helpful. Perhaps I need to be brave and stop the Naproxen and paracetamol? To be fair to the Dr I was already on the Naproxen and paracetamol prescribed from the pharmacist referral to try to cope before they referred me to the GP. The GP diagnosed and prescribed prednisolone but didn't offer a suggestion either way on whether to stop or carry on with Naproxen and paracetamol. Initially I stopped the Naproxen and paracetamol and just took the steroid but couldn't cope so then added them back in after a few days. Then got to a manageable level but could it be that was achieved by the Prednisolone kicking in a bit delayed? I had a follow up appointment with the Dr a week after being on the steroid so she knows I am still taking Naproxen and paracetamol. She did say when we review next week after 3 weeks on the steroid we'll only come down a dose if I have been pain free for a while (?) plus she implied with no naproxen and paracetamol but didn't explicitly say that.
I’d be inclined to stop one initially rather than both together… so maybe stop one for a week.. and if you feel okay then stop the other… but you need to discuss the naproxen cessation with GP, especially if you’ve been on it for longer than a couple of weeks.
I agree with everything that's been said. A strong, rapid response to prednisolone is a crucial part of confirming the diagnosis of PMR. That's especially important as the average age at diagnosis is about 72 and you are an outlier at 54. What's at stake is the possibility of ending up on long-term steroids unnecessarily.
Three questions: a) how long had you suffered before the diagnosis? b) Did you have blood tests? c) What were the results for CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate)?
Thank you for your help. In answer to your questions a) gradually over a couple of weeks then intense debilitating pain stiffness for 2.5 weeks before saw GP and got Prednisolone. b) Yes to blood tests these first 2 results together with very good response for shoulder neck pain (Virtually cleared) in 1st week on prednisolone confirmed GP's Polymyalgia diagnosis; 1)Erythrocyte sedimentation rate 86 m/h [0.0 - 19.01; Above high reference limit2)Serum ferritin level (XE24r) 477 ng/ml [11 - 307]; Above high reference limit; *** NOTE : Ferritin is an Acute Phase Protein. ***; *** The commonest cause of a raised value is ***; *** infection or inflammation ***
I don't seem to have anything for the CRP one you mentioned.
These other ones were also out of range:
Serum folate level (42U5.) 22.2 ng/ml [3.1 - 19.9] - Above high reference limit
This one puts me bang on top range of prediabetic. 😕 So they will redo at end of the month: Haemoglobin A1c level - IFCC standardised (XaPbt) 47 mmol/mol [26 - 41]; Above high reference limit;
Monocyte count - observation (42N..) 1.19 10^9/L [0.2 - 1] - Above high reference limit
Platelet count - observation (42P..) 557 10^9/L [150 - 400] - Above high reference limit
Neutrophil count (42J..) 8.72 10^9/L [2 - 7] - Above high reference limit
Total white blood count (XaIdY) 12 10^9/L [4 - 10] - Above high reference limit
Thank you for the rapid and comprehensive reply. The delay before diagnosis and testing is important because it gives time for any minor injury or routine infection (which can also increase inflammatory markers) to resolve before autoimmunity is considered. It is assumed the patient will rest and not do anything to aggravate or delay the healing process during that time of course!
I presume the ESR result is not really measured in "m/hr"! That would be equivalent to a score of 86,000 mm/hr and you'd either be in the Guinness Book of Records, a coffin, or both! You're not a superhero with uranium blood, are you?
It seems odd not to test for CRP, as that is the primary, trusted, longstanding blood test for PMR. ESR is the secondary test. That said, the paper linked below suggests ferritin does show promise as an alternative to CRP in suspected cases of GCA/PMR:
pubmed.ncbi.nlm.nih.gov/222...
I'll let others comment on the other test results. I just wonder how the doctor knew it was the prednisolone that worked in a week, and not the NSAIDs?
Hopefully, your test results will continue to improve, along with your symptoms, over subsequent weeks.
Actually, many experts feel that the ESR is a better monitor of ongoing disease activity in PMR as well as significant in the diagnosis. It is also cheaper.
"The ESR is the most useful serum laboratory test for diagnosing polymyalgia rheumatica and temporal arteritis. Although the Creactive protein level is typically elevated in patients with these conditions, it provides no better data than the simpler and less expensive ESR."
aafp.org/pubs/afp/issues/20...
I'm sure it is, if the ESR is elevated. This 2018 paper reported studies showing that it often isn't. That's why both tests are recommended.
ncbi.nlm.nih.gov/pmc/articl...
Where I live (except perhaps for initial diagnosis) the doctors are not allowed to ask for both tests at the sme time so at first they checked ESR then later CRP and current doctor continues with CRP, which does seem to track well with my symptoms, or improvement thereof. I think labwork for ESR may be more time sensitive?
Hi HeronNS, that's interesting. Where do you live? Thanks for your input. 🙂
In Nova Scotia.
Thank you so much for all the info and help. Yes a typo there it was mm/h (Erythrocyte sedimentation rate (XE2m7) 86 mm/hr [0 - 19] - Above high reference limit).
Actually what happened is before I saw the Dr I was referred to the Pharmacist on 20/3 who prescribed the Naproxen which I took together with paracetamol but with no relief whatsoever. Then got a Dr appointment on 26/3 where she prescribed the Prednisolone and took the blood tests. Then I saw her a week later when she had the blood results and I had the huge improvement from a week on the Prednisolone. Possibly also relevant I hadn't had any infection or injury I was aware of to cause anything. Many thanks for your input. 🙂
Glad it all stacks up. Fingers crossed it will run its course quickly. Just don't overdo things and don't rush the taper. Your immune system must return to normal before the symptoms will.
Thank you. 🙂
I still don't really understand if the steroid sort of "mops up" the inflammation my immune system has pumped out or if it just masks the symptoms. I assume it's not actually having any effect on the amount of inflammation the immue system is putting out (hence why you say we're waiting for the immune system to return to normal). Am I correct in thinking there's 2 pockets of excess inflammation from what the immune system is up to in that 1) Stuff that's been built up whilst everything has not been treated since nothing's been dampening it or mopping it up plus 2) Whatever inflammation it's currently producing?
Just trying to get my head round it! 😂
It's such an odd concept that I need to be wary of "overdoing it" rather than base it on how everything is feeling.
I feel like I'm erring on the side of caution all the time but possibly not a bad thing since I'm at the start of the journey. So useful to have everyone's insight. Thank you. 🙂
Here's an analogy for the advice to not overdo things when you feel better. My husband told me about his grandmother who had quite bad back pain, and whenever she felt better she would rush around doing everything she could while she felt up to it. You know what happened next, don't you! Just because our illness is invisible doesn't mean it isn't affecting us just as much as a pulled muscle or a broken bone. It's also a bit harder to get others to understand, because we aren't obviously sick. We aren't hobbling around with a cast on or using a crutch or wearing a bandage, we don't even have spots! In fact we may, thanks to pred, look particularly well.
I'd like to add a bit of caution re the PPI you are taking. Once you've shed the Naproxen completely, you may be safe to take pred without the medication, provided you always, without fail, take it with some food. Doctors are determined to have us taper off pred because of the potential effect on our bones, but drugs like Omeprazole can also put one at risk of bone thinning when taken for an extended time. By all means continue with it if you need it, but balance things out by eating and exercising to maintain bone health.
Thank you HeronNs, Very helpful. Yes today we went out with my sister who can't walk very far without stopping due to lots on ankle issues and previous ankle surgeries. So overall even though the walk took longer it was way slower than I would normally walk with loads of very short sitting down stops. So I think in terms of effort it was similar to my normal daily walk. But it was really weird because she kept asking me "are you alright, do you need to sit down and rest" but of course I never did because presumably it would only be afterwards I would realise I'd done too much. Thank you for the info too about the Omeprazole. I do intend to stop taking g that as soon as I've stopped the Naproxen.
I'm really hoping my doctor will be helpful and not too pushy when I get to the tapering stage because although she gave me a chart (see attached), she said it's just a guide and can take longer and that they only go down a dose if you've been painfree for a while on the current dose. 🤞
That chart is a bit optimistic. For GCA and PMR the likelihood of needing pred for less than 2 years is very low, and some of us take longer. Patients have devised their own taper methods, and I took a couple of them to show my doctor and she was quite agreeable to my using one. They are to be found in our FAQ post under Tapering Plans (I think).
A rule of thumb is to never taper more than 10% of the dose at one time, and not to taper too quickly, starting with 4 to 6 weeks at the first dose, not 3 weeks! I personally was fine with 4, or maybe it was 5, weeks to start, and my doctor had me tapering by 1 mg a week until I felt return of symptoms at 9 mg, and went back to 10, starting a slow method from then on. I was at 3 mg by the end of the first year. But many people cannot taper that quickly, and may even need more than 15 to start. I think it must drive doctors a bit nuts dealing with PMR patients because the only thing that is really certain is that we are all different!
The good thing is your docter expressed the knowledge that tapering can be variable, so as soon as you feel your symptoms are not properly under control, stop tapering and go back to where they were good, and slow down! Another rule of thumb to keep in mind for later is, the lower the slower. This often means tapering by only 1/2 mg below 10 mg. And, as PMRpro put it, "It isn't slow if it works."
Thank You HeronNS, That's all really good to know. Both from a managing my expectations point of view and to facilitate Tapering discussions with the Doctor when I get to that stage. I like your idea of taking some example plans that have been successful for others in to show the doctor. I feel I have a bit more of an informed plan of what my aims are for my discussion with the Dr on Tues. So if I'm not painfree to ask for a higher dose of Prednisolone to try.
If she suggests staying at 15mg for a little longer first to see if things do further improve do you think that would be worth trying? Or do you think it's more likely 3 weeks would have been long enough to reach painfree if the steroid dose was enough to have that effect?
Whereas if I am pain free by then I'll ask to stick there a bit longer before beginning tapering. Though she implied they'd only suggest tapering after you've been painfree consistently for a "while".
I do understand every individual is different and there are lots of factors involved.
Thank you for your thoughts on this. 🙂
Three weeks seems to be the preferred option nowadays -but used to be 4-6weeks which in my mind was more sensible…
Thank you DorsetLady. Please can I clarify (probably asking an impossible question here 😂); out of the 4-6 weeks how long to get to painfree at that dose (if it will) and assuming that is achieved, how long should you be painfree before considering the next taper down?Thank you so much for your advice. 🙂
It is pretty much an impossible- and very individual - question. But the ‘at least 70%’ improvement’ is the benchmark quoted in the guidelines. Some get 100% improvement and almost immediately- for some it take a few weeks. Which is why I think 3weeks is pushing it….4 weeks should give a good indication- and if the patient doesn’t have significant improvement by then, then the dose probably isn’t high enough. By 6 weeks at initial dose there really shouldn’t be an any built up inflammation lingering… if that’s the case then you can taper.
I think most people are expected to taper too quickly when there is still some existing inflammation loitering so the Pred is trying to cope with that and the daily shedding at the same time…it’s working doubly hard..
Thank you DorsetLady. Sounds like it may be worth staying on the current dose a little longer if I'm still not almost painfree after the 3 weeks. Possibly I have had 70% improvement since before having the steroid. Though I wouldn't like to stay with the current level of pain for too long. Following all the info everyone has given at least I can have a sensible discussion with the Doctor on Tuesday. Perhaps she'll say continue on current dose for a further week then if no improvement try upping it.
At the moment I am so looking forward to the possibility of being pain free I definitely won't be in a rush to taper too quickly. 🙂
I agree with DorsetLady, four weeks is preferable. If you are not at least 70% improved, then you likely need a higher dose, but wait until you've been NSAID-free for a few days to see if that makes any significant difference. Hopefully pred will be doing its thing. 
I just took the papers with me to an appointment and asked her what she thought and thankfully she was fine with the idea. I didn't go in declaring I was going to taper that way (although I intended to, no matter what she said). Always good to keep the doctor on your side. We have to be a team, doctor and patient, to get the best outcomes, and it sounds like you do have a GP who is on your side!
Excellent advice HeronNS, thank you. So sounds like I'm probably still at the "wait and see" stage whilst gradually cutting out the Naproxen and then the paracetamol before the plan forward can be made.Very good point about being respectful with the Dr and fostering a working together relationship. Yes, I feel very lucky - I'm really impressed with my Doctor so far. I was quite amazed to be diagnosed so quickly, to be given something that immediately gave such relief and pleased that the blood tests were so comprehensive. Also amazing that there seems to be continuity of care with the same Dr. Couldn't really be more positive so far. 🤞
Thank you for your sage advice. 🙂
I hope easing off the other painkillers will help avoid what was probably a rebound effect before. But I think someone suggested that you might need a somewhat higher dose of pred, 15 mg sometimes isn't enough at the beginning, so if you do get some pain back again you might try an extra tablet of pred and see what happens? 🍀
That's definitely something to consider HeronNS. I'm keen to get off the Naproxen and paracetamol. I'm looking forward to discussing everything with the Doctor on Tues. Perhaps she will agree I could try it and see the effect. As always thank you for all your help. I don't know what I would do without this forum. 🙂
"do you think it's more likely 3 weeks would have been long enough to reach painfree if the steroid dose was enough to have that effect?"
That is 2 unknowns - I responded to pred in under 6 hours to get the 70% improvement but it was actually a few months before ALL PMR-related pain had improved as much as it was going to. Hips, feet and hands took longest. Many people are never pain-free, whatever the dose. The best approach for everyone is to stay there long enough for symptoms to be stable and there being not much difference from day to day. If your inflammatory blood markers register for you, they should have fallen and be stable within normal range.
It used to be 4 to 6 weeks and our impression is that people did a lot better in the longterm with that. It is all very well hurrying to get the patient to a lower dose of pred - but all too often that is at the expense of flares, returning to higher doses and overall, more pred and certainly more discomfort for the patient. Not to mention far more demand for doctor's appointments that just aren't available. When you are flaring, don't know what to do and can't see the same doctor for continuity, you really can end up in a longterm mess.
Yes it is only a guide… mine gave me a similar one at beginning of GCA [obviously much higher dose and longer timescale}.. have to say, it didn’t end up anything like the real thing..😉
Thank you DorsetLady, that is a good reality check. I guess it's just a plan for them to start from. Really helpful for me to fully understand that most people take way longer. It seems a key factor for success is two way dialogue with the Dr and patient with the patient taking some control and not blindly tapering at the rate suggested if it's not working/doesn't feel right.Thank you so much for your invaluable help. 🙂
Pred combats the inflammation - it is about the most powerful antiinflammatory available. This concept of "masking" makes little sense really - unless the inflammation is actually eliminated, you won't get rid of the symptoms. Except if you look at it as pred "masking" the fact you are ill with PMR - it cures nothing, the actual disease process that creates the inflammation is still there in the background, chugging away and producing the IL-6 substance that makes the inflammation. So if you don't take enough pred to deal with the amount of inflammation, there will be some left over and over time it will build up again, just as a dripping tap will fill a bucket over time until it eventually overflows.
If you want to know exactly how pred works here is a scientific explanation:
"Prednisone decreases inflammation via suppression of the migration of polymorphonuclear leukocytes and reversing increased capillary permeability. It also suppresses the immune system by reducing the activity and the volume of the immune system. The antineoplastic effects may correlate with the inhibition of glucose transport, phosphorylation, or induction of cell death in immature lymphocytes. It may have antiemetic effects by blocking the cerebral innervation of the emetic center via inhibition of prostaglandin.
Prednisone is a prodrug to prednisolone, which mediates its glucocorticoid effects. Prednisone is a synthetic glucocorticoid that has both anti-inflammatory and immunomodulating properties.
After cell surface receptor attachment and entry into the cell, prednisone enters the nucleus, binds, and activates specific nuclear receptors, resulting in altered gene expression and inhibition of proinflammatory cytokine production. This agent decreases the number of circulating lymphocytes, inducing cell differentiation, and stimulates apoptosis in sensitive tumor cell populations."
Thank you so much PMRpro for this excellent detailed explanation. I did need to read it 3 times. 😂 So very helpful. I feel really blessed to have access to all the incredible helpful kind patient people on this forum. I hadn't realised that Prednisolone and Prednisone weren't the same prescription drug. Turns out the one my sister had was the latter (for about a year after a severe allergic reaction that hospitalised her). So slightly different to the Prednisolone I'm now on. Very interesting how your body turns one in to the other with lots of effort from the liver (is that why PMR sufferers are given Prednisolone to protect the liver I wonder?).Thank you so much. 🙂
Which you get tends to depend on where you live - the USA tends to use prednisone, the UK prednisolone and it is recommended that anyone with a dodgy liver should be given prednisolone.
Ahh! Makes sense - my sister was in the States when she was given Prednisone. 🙂
Exactly how PMR works (its aetiology) is not well understood. However, its close association with GCA suggests it works in a similar way. A faulty immune system sends huge numbers of unnecessary cells to attack healthy tissues. This makes the tissues swell up, which is called inflammation. The swelling causes stiffness and pain.
Corticosteroids, such as prednisolone, mimic the body's natural hormone cortisol, which regulates the immune system. The more you take, the fewer immune cells are made, and the quicker the swelling calms down. This is good news when the problem is autoimmunity, as described above. It would not be good news if there was a real invading pathogen, such as a virus, bacterium, fungus or parasite. Fighting genuine infections is what the inflammatory response has evolved to do. Sadly, it sometimes it goes wrong.
We don't know why the immune system malfunctions and decides to attack healthy tissues. Nor do we know how to stop it happening. What prednisolone does is reduce the scale of the attack while the body (hopefully) sorts itself out. That takes time.
Thank you AtopicGuy, for such a helpful, clear explanation. Being able to understand more of what's happening is making me feel a little more in control. It's all so interesting and even though having PMR means something is a bit out of kilter it is a reminder of how amazing the human body is. It makes be more determined to eat well (anti inflammatory) and give my body the best chance of getting back to equilibrium.
It also puts into focus that once you reach the correct painfree steroid dose the real driver for tapering is not really trying to get off the steroid asap it should actually be driven by whatever time your own immune system needs to stop misbehaving.
Thank you for all your insight. 🙂
Indeed. Just remember that cortisol is also involved in many other regulatory systems: evolution tends to do work that way. That's why steroids have such varied and troublesome side effects.
Welcome to the forum! You will find the support and information from these member invaluable, especially at the beginning of your PMR journey.
I too had been on enteric coated Naproxen (2 X 500mg) daily for 3 months prior to my PMR diagnosis. It did little except take the edge off my pain and stiffness. When I started pred (20mg daily), my GP advised me to stop taking Naproxen. I was fortunate that the pred kicked in about 6 hours after taking my first dose of pred, and my symptoms were reduced approximately 85%. I didn’t start tapering until 6 weeks after my initial dose.
After a few months I did notice that I was stiff in the mornings. After a discussion with my GP I began to split my pred dose (evening and morning) so as to get relief for a full 24 hours and alleviate the morning stiffness. This has worked well for years now.
You are in the very early stages so please feel free to post your questions as need be. We are here for you.
Thank you. Good to hear of others that were on naproxen too at times. Though I do think it's probably not doing anything for me. Interesting to hear about splitting the pred dose. I feel I am getting well informed to facilitate my discussion with the Dr. Thank you.
Hi PMRCanada
This is interesting , I’m currently on 4mg and have morning stiffness till the steriods and 1 x 500mg paracetamol kick in (I also have a shoulder issue either impingement or frozen, under investigation by the Dr)
My question is would you split 2mg in the morning and 2mg in the evening and if so, just before bed or early hours?
Ps visiting Canada in May (Montreal/Quebec/Ottawa) 😎
Thanks
At this stage taking pred just before bed is not recommended as it can interfere with the return of adrenal function. It is a very low level of pred in the blood at midnight that triggers the production of cortisol next morning.
What time are you taking your pred at present? Do you wake in the night for a loo stop? That is often a good time to take part of a split dose.
Hi PMRpro,
Thank you for your message , I sometimes get up for a loo break but rarely as I’m sleeping through a good 8 -9 hrs a night. I’m currently taking my 4mg at breakfast around 7:30/8am. If I were to get up through the night what time would be good to take half the pred? Thanks
How early do you wake? As PMRCanada explains, 2am is the ideal time to take your pred, Otherwise, as early as possible may help. The other option might be to take half with breakfast and the other half later, say lunchtime, which may extend the antiinflammatory effect until the next dose is due - which is often a problem. It is 12 to 36 hours depending on the person - if you are at the lower end, it will have worn off early in the morning which is when the new batch of inflammatory substances is released into the body and there is nothing there to stop their action.
To clarify I take my evening dose at 11pm but it is in enteric coated capsules (that I bought online). This way it is on board (in my system) by around 2-3am. I had tried getting up at 2am but found it interrupted my and hubby’s sleep as I needed to eat something with uncoated pred tablets. Sometimes I would drop part of my dose in the dark and realize it only the next day when I would be stiff/sore (I would find the dropped medication next to/under my bed). Other times I would sleep through the night and miss that dose. Hence the enteric coated capsules as there ate no coated pred tablets in Canada (but they are available in other countries).
I take my morning dose at 11am and this lasts until I take my evening dose and go to bed at 11pm.
Enjoy your visit to Canada…these are wonderful locations and usually nice weather in May.
Hope you enjoy your visit. If it's nice there should be lots of tulips in Ottawa. We'll be visiting our daughter in Ontario, but will only see your locations (all of them actually) from a train platform!
I have pretty much the identical symptoms to you. The leg thing came later (began with neck and shoulders). I too wondered why you are taking Naproxen - I tried that before getting steroids and it was no help. Plus I don't think one is supposed to mix NSAIDS with steroids? Once I realised pred worked, I didn't need anything else.
Thank you for your reply Creas. That's heartening to know that you found the pred worked without anything else. Please can I ask what dose they started you on and did you achieve pain free within the initial 3 weeks on the steroid? Thank you very much for your help.
I am very grateful for this forum and so many people kindly sharing their experiences and insights. It's an absolute godsend. I feel my understanding has of Polymyalgia has improved so much. 🙂
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