Are flares as debilitating as PMR original presentation

They would be likely to be like that if your doctor tells you to reduce from 20 to 15 in one fell swoop - and even worse to 10mg! 10% at a time is plenty - 20 to 17.5 to 15 usually works though.

Using the DSNS approach you shouldn't have a problem PROVIDING you are honest about any suspicions you have about returning symptoms. Ones which appear immediately you change the dose are usually a reaction to the lower dose, called steroid withdrawal and they usually improve over the following few days. Signs the new dose is too low take a bit longer, unless the drop was very big, and then get worse day by day. The DSNS makes it more obvious we think - you might feel strange the day you take the lower dose but after a few attempts and going back to the old dose most people find their body stops complaining and accepts the new dose.

I definitely didn't drop to 15mgs - used the mid slow taper ten per cent at the time. Diagnosed June 2017, and just down to 10mgs. We're all different but I reckon it 's good to be conservative to start with. You are feeling good because of the steroids but the inflammation is chugging along in the background!

OregonHazel,

I have had 2 or 3 flares prior to my most recent BIG one a few weeks ago. The smaller flares are noticeable, resembling the original pain but not anywhere near it. On a scale of 0 to 10 (10 high), my smaller flares have about a 5 or so when I'd normally be living with a 2.

My most recent flare, however, was a 9. It was BADDDDD. No doubt about it. A direct result of an injury combined with much too much exercise. I pushed my body over the edge.

But I was very fortunate to be able to bring it back down to a reasonable level within a few days by increasing my dosage from 1.5 mg to 5.0 mg.

Hope that helps.

Oregonhazel, l followed my Rheumy advice right into a flare that put me into a wheelchair. My Rheumy here in NM does not believe in DSNS, but I do and follow the protocol religiously, with never more than 10% reduction. A flare is caused by inflammation building up in the body, if the buildup is quick hard flare, if the buildup is gradual less severe flare, I have had both . Good luck try and take it slowly and you will probably have less bumps on your PMR journey. Stay active, positive with a smile. 🙂

So with DSNS method I will be able to identify the beginnings of a flare and then I respond by asking for immediate increase to my last dose?

Maybe I should print out the details of DSNS method and try to persuade to follow this plan. Or maybe my GP is already familiar with DSNS and I am worried for nothing 😃

thanks all for your patience with me, I may be a bit slow to process the complexities of PMR but I will catch on eventually

I started on 10mg September 2018, tried twice to reduce to 9mg , but each time shoulder and back pain returned after a few days, went back up to 10mg until I changed my rheumy early part of this year. He gave me a booster shot (the beginning low dosage of 10mg was never quite enough). After that I was able to reduce by 0.5 increments to 8.5mg, about to reduce to 8mg this week. So, yes, for me the dead slow method is beginning to work, and I am completely pain free so far (she touches wood....)

Speaking to the subject of reduction of pred dose......I have been taking Actemra injections on the advice of my rheumy for 6 weeks or so.. He advised me to reduce from 15 mg to 10 mg of pred, which I have done about 5 days ago. I have had some discomfort but my thinking was if I could just suffer thru my body would get used to the lower dose, and put me closer to getting off the pred completely. However, I woke up this morning with a very sore, tight knee and have had to walk with a cane all day today, not due to an injury. I almost upped the dose back to 15 mg but decided to tough it out to see if things improve.

Oregonhazel, I started on 20 mg and was down to 7 mg when I flared and ended up in a wheelchair, had to increase 30 mg to get relief. My flare was much worse, the inflammation got too far out of control. Now I take tapering slow and easy using DSNS. 🙂