Is it back ?

[CarolF1312]

Hi All, I was really hoping that I wouldn't be seeking your advice again for quite some time. However, after 5 months Pred free I think PMR may be back. For the last 3-4 weeks I've had a stiff neck. Particularly in bed and first thing in the morning ( similar to how it started last time) I've also developed what I can only describe as a tightness across my back.As I've been discharged by my Rheumatologist I need to contact my GP and would like your advice before talking to them.

Should I follow the protocol for a Flare ? Maybe take 5mg of Pred for a week and then drop down to 1mg

Or is it likely I'll need to start the whole process from 15mg and start gradually tapering again.

I guess the GP will want a blood test. However my inflammatory markers have never been really high so likely they'll suggest it's not PMR!

Just to add to the confusion, I had my second infusion of Zoledronic Acid yesterday. On reflection maybe I should have postponed until I get this under control.

Any advice you can offer would be greatly appreciated.

[DorsetLady PMRGCAuk volunteer]

If you catch it quickly you shouldn't need to go back to 15mg. In that timescale sounds as it if never fully went away, and has taken that long for you and your body to feel the effect.

Try what you suggest -and stay on 1 or 2mg until you have discussed with GP.

[DorsetLady PMRGCAuk volunteer]

no "shouldn't" - having coffee out - not concentrating - thanks!

[CarolF1312 in reply to DorsetLady]

No problem, I knew what you meant. Many thanks for the fast response x

[PMRpro Ambassador]

Five months is a surprisingly common interval for inflammation due to very low disease activity to build up enough for you to notice. As DL suggests, using the flare protocol should be enough to nip it in the bud and get back to 1mg and work from there. Half a mg on alternate days has been known to keep it quiet - but zero was simply a step too far.