is this a flare?

[Knarllyknees]

After starting with pmr a year ago I’ve tapered down from 20mg to 2mg of prednisone and felt I was making good progress.

About 2 months ago I hurt my right wrist carrying some bricks and that developed into a swollen painful hand. That has slowly improved but I have developed a nagging pain/uncomfortable pain in my right shoulder that has stopped me being able to swim crawl stroke (my exercise of choice) and some discomfort in my right knee.

Is this a flare? I’ve been reluctant to up the pred but I’m getting very fed up with the nagging pain. What do you suggest?

[SheffieldJane]

You really cannot continue with your normal exertions with this disease. Muscle recovery is very slow. You have obviously been overdoing things and need to rest these muscles. I would be tempted to up my dose a bit to help things along. Frustrating as it is you need to pause the heavy work. You may have a long time to go with this significant, systemic disease, you must treat it with respect. Best wishes!

[DorsetLady PMRGCAuk volunteer]

Does sound as if you have gone too low - and to be at 2mg within a year is pretty quick. You could try the flare protocol - dropping back to 3 or 4mg -

healthunlocked.com/pmrgcauk...

But as SheffieldJane says your PMR is still there and that needs to be treated with respect..so maybe ease up a bit.

[Koalajane]

you are tapering very fast. Take it easy now

[SnazzyD]

Sounds like a combination of injury with over doing physical activity and your autoimmune inflammation breaking through. You will be more susceptible to injury of muscles and ligaments due to both PMR and Pred so you really need to cut down and build up annoyingly slowly or find your level, giving a couple of days between exertions. No pain doesn’t mean get back to normal unfortunately. To be at 2mg after only a year is fast going and it isn’t surprising that your autoimmune activity is no longer being covered by the Pred dose. Sounds like you need the flare protocol as DL says and then slow right down in every way.

[Knarllyknees in reply to SnazzyD]

Thanks for your help and advice- you are all a great support. I’m now planning to add 5mg to my dose for a week and then hopefully drop to 3mg for a month or more before tapering further

[piglette in reply to Knarllyknees]

Hopefully that should work. At least you will then see if you get relief from the increase which you should do. The trouble is PMR likes winning, so you have to stamp it on the head, so it does not get up again!!

[PMRpro Ambassador]

If it is one-sided then it is less likely to be PMR than due to some sort of injury but it also sounds as if you have got to too low a dose of pred to fully manage the PMR. Try a bit more pred and ask the GP about potential injury - possibly physio would help.

[Knarllyknees in reply to PMRpro]

Thanks for that- I’ll up the dose for a few days and see what happens