Flare on Reducing Pred (or perhaps not)

It does sound it might be other aches and pains as opposed to PMR/GCA. often arthritis type pains particularly are helped by the Pred. People are then surprised they start coming back as they reduce. 

Hi Jones...first off, what an incredibly fun sounding ( if not too strenuous) day!! Yes, that could definitely explain the crummy symptoms! However, being that I'm 2 months new to this confusing stuff, I tend 2 think it may well be the reduction of the prednisone. I started on 15mg but was incredibly anxious 2 get off asap and try 2 avoid the myriad of sude effects. Given that I'm so tenacious (and stubborn) I cut down 2 10mg in 3 days! Since then it's been a nightmarish rollercoaster of all kinds of issues. Suffice it to say, I'm now back on 14.5mg and holding. And I too had an extraordinarily short period ( about 2hrs!) of relief after taking my very 1st dose.

Sounds like myofascial pain syndrome - leading to spasmed muscles which hurt! And if the piriformis is involved then it will irritate the sciatic nerve which can cause pain down to the knee and beyond. It can come in various levels up to agonising! It is caused by the same inflammatory substances as PMR but they are concentrated in trigger spots in the muscles, located in pairs in the shoulders, about rib level and in the lower back about where the baby's dimples are as well as in the fascia - the transparent skin covering muscles like you find in meat and poultry. Any uneven stress on back muscles will irritate them and the muscles then go into spasm to protect themselves from further injury - walking on uneven ground is enough for me, bending in strange positions and starting a tractor would have me begging my rheumy for help!

Higher doses of pred will help the problem loads - especially if you also do rather less at the same time. I don't think that the lower dose is the cause - but the higher dose probably was helping. However, he can't stay at a GCA dose forever just to deal with back ache - there are much better ways of dealing with it. I have therapeutic massage from a physio at the hospital. Before pred, Bowen therapy and my osteopath helped a lot. Pilates improved my core muscle strength and supported my back muscles. There are other myofascial release techniques - NHS doesn't offer them usually although I did have 2 physios in Durham who understood it. Far too much of NHS physiotherapy is based on exercises you go away and do yourself - but the problem is that FIRST the muscles have to be stopped from their spasm because you can't train them when they are in spasm.