Fracture Healing and Prednisolone

Gosh poor you! you didn't need an accident on top of PMR. Well done for tapering down so quickly.

I don't have a lot of experience but broke my ankle just standing up a year ago. I have been on pred for 4.5 years going from 20 to 3 and then back up with a couple of flares. Am currently on 8.

Although I obviously thought the break was caused by side effects of thinning bones my ankle healed really well in 6 weeks and even stood up to a pasting of falling downstairs and re tearing ligaments. I am hopeful therefore that the pred is not such bad news and would be very wary of coming off at this time.

It is not only the PMR you have to think about but also adrenal function - even after just 6 months you still need to taper slowly or there is the risk an adrenal crisis. You would need at least 2 or 3 months to get to zero safely - by which time the bones are likely to be healing well, providing you are sensible about what you do so as not to disturb the bones again.

There are a lot of people on the PMR forums who have had fractures and orthopaedic operations while still on pred and healed fine. Your bone density is pretty well normal and alendronic acid should not really be used at that sort of t-score, calcium and vit D supplements and weight-bearing exercise is usually considered by experts to be sufficient.

Like Jillian, I think you would be unwise to stop the pred particularly since a resurgence of the PMR affecting the shoulder girdle would be likely to make any rehab more difficult.

Hi Tonche, I am an active Male also, bicyclist, ski instructor, I eat anti inflammatory organic diet, plus supplements calcium, magnesium, vitamin K2 and MSM. I would not rush off the Pred, I did once and had a debilitating flare. Good luck on the rest of your PMR journey. Try to think positive and stay active. I know this sounds crazy, but try to smile. 🙂

If I were you I would reduce exercise, not prednisone. If you were not on pred, how would you recover from the injury you have? Do exactly the same. While there are many scary studies about the impact of pred, (like the one that you posted), there are also studies like Mayo clinic that indicates that long term pred use is not decremental for health, when compared to the same age group individuals. The only exception is cataract incidents which are higher for PMR patients.

I have been on pred for 4 years now, and my bone density is higher then average and equal to young adult bone density. I think it is because of my life long active life ( ex triathlon ) and healthy diet. I do take calcium , Vit D and Vit K2 since the onset of PMR.

Hi, Im 62 and on 2mg pred ,taken most of this year to taper to there. I fell off a patio step earlier this year and broke my fibula down near the ankle. I healed fine and had no troubles healing, my biggest concern. My Primary care MD also had me get a bone density test earlier in the year to see where I was and since I was going to be on the Pred for a while. It was great, no loss at all. I eat for optimal nutrition and really try to monitor my nutrients etc. Also in sept I was working in my garden and strained some intercostal muscles in my rib area. excrutiating! went to Urgent Care. I was tapering from 2mg to 1.5 at the time and though the Dr told me to increase for a while I wanted off the Pred and tried to force it and ended up in a big flare that lasted for 6 weeks. Ive since realized my body is not ready to go below 2mg so Im staying put for a while.I find that when the proper Pred dosage and my PMR are working together Im very clear headed, really good energy and strong feeling legs. When things are off I do feel funky and awkward at times. Ive found for me this is not the Prednisone but the PMR inflammation, a flare. This is a great support group helped me a lot thru all this. Dr's dont help much with living while on Pred.

As I understand it the greatest effect on the bones is in the first three or four months of taking pred. I do not know why, perhaps because our dosage is higher then, or perhaps in some way the body adapts. In any event I think you should just do all the bone healthy stuff, eat right, we know you exercise, are you getting weight bearing in that, simply walking will do, and take a few supplements, including Vitamin K2. I improved my bone density between scans during a years when my dose was still above 5 mg for most of that year, although down to 3 by time of the second scan. Medication advised after first scan (refused by me) and recommendation dropped after the second scan.