Flare management

[Dorothy61]

Having been down to 0.5mg of pred for 2 months I’m now experiencing what I assume is my first flare (after nearly 4 years of PMR). This is probably due to a number of issues arising simultaneously and causing a degree of stress. Symptoms primarily stiffness and tightness in neck. After a week of suffering I decided to increase pred to 5.5mg which has eventually started to have an impact. I’m away next week and keen to keep pain levels low. Tomorrow will be day 7 of increased dose and not sure how to proceed. Should I wait until my return (day 14) and then reduce to, say 2mg and then stay there for a few more weeks?

I’m also on holiday at the beginning of June (involving long distance travel) so very keen not to rock the boat.

Any advice would be appreciated. Thank you ☺️

[DorsetLady PMRGCAuk volunteer]

Sounds in line with usual advice - hope it works for you… and probably not wise to try and reduce any lower than 2mg before your long haul travel. Leave it until you get home…

If your haven’t seen this re long haul, might give some extra tips-

healthunlocked.com/pmrgcauk....

[Dorothy61 in reply to DorsetLady]

Thanks for your reply. So if I reduce from 5.5mg to 2mg after the trip next week that will be 14 days on higher dose. Will that be ok or should I taper more slowly?

I will definitely stay on 2mg for my holiday and take plenty of pred just in case.

[DorsetLady PMRGCAuk volunteer in reply to Dorothy61]

No need to taper - that’s what the flare protocol is all about - so long as you aren’t on the increased dose for more than 14 days - it’s fine..

This link has explanation -,

healthunlocked.com/pmrgcauk...

[Dorothy61 in reply to DorsetLady]

That’s great, thanks for confirming and providing the link 😊

[PMRpro Ambassador]

I think that sounds fair. But I don't think a return to too close to 1/2mg will be a good idea, I suspect you need a tad more, even if you don't need 1mg. Too much is preferable to too little!

And enjoy all that travel ...

[Dorothy61 in reply to PMRpro]

Thanks for your reply. I think you’re right in that I might need a bit more than 0.5 for a while. It’s disappointing as prior to this blip I was looking forward to tapering further. However, I know full well from this forum that a lot of people experience similar problems and PMR definitely has its own agenda!

[PMRpro Ambassador in reply to Dorothy61]

It certainly does!!!