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amkoffee amkoffee

I need advice on dosing

I have been experiencing a great deal of pain in both my hands. I've been working with my rheumatologist for many months about this. Back In October I had an MRI done on my right hand. I did not do both because I knew my back could not handle it because of the position I had to be in. I can not do another MRI because the first one caused me unbelievable pain on my left side. But the MRI showed that I had osteoarthritis in my thumb joint and inflammatory arthritis in the rest of my right hand. The problem is that my hand pain has significantly increased over the past few months. So today my rheumatologist did a regular xray on both hands. And really, the only thing that showed up was the osteoarthritis in my thumbs which we alley knew. Her suggestion was that my pain might be worse because my inflammatory markers are raising. She suggested I try going up to 10 mg. I am currently at 8 mg. I hate the idea of going up because I have worked so hard to get where. I was hoping the people in this community would give me their opinions on whether I should increase my dosage or try to stay where I am at. One last bit of information, when I am late taking my Pred in the morning or having a flare the very first thing that starts hurting are my hands and my forearms but my forearms are not in pain now and my hand pain is different then it usually feels like with PMR.

13 Replies

  • Anhaga amkoffee

    I can remember seeing a doctor at a walk in clinic not long after I started taking pred for PMR.  It was an infected bug bite.  He said something about an anti inflammatory if I felt I needed something, but then when I said I was on pred said that was the best anti inflammatory.  Please don't suffer.  You know what we've been told lots of times - increasing the dose by as much as 5 mg for a few days will not compromise your taper.  If you find it helps then you manage it the way you would manage a regular PMR pain.  If it doesn't help, you just go back to the dose you were on, if that had been sufficient.  I know lots of people say that flares are often different form the original disease, but they are still relieved by pred. 

    I do hope you feel better soon. Hugs.

  • Michdonn amkoffee

    Amkoffee, I would bump up the dosage, hit a flare hard on 8 mg increase by 5 or 6 mg, if no change drop back to the highest dose in your taper. If that additional Prednisone you should feel better if it is PMR. Good luck hope that does the trick! ☺️

  • megan42504 amkoffee


    I’m so sorry for what you are going thru.  I was diagnosed with PMR in January, so I’m new to this ride.  My wrists, then hands have been the last to be horrible.  Started out with an orthopedic surgeon as the pain in my knee was unbearable.  Cause me no pain now, probably cause of the prednisone.  Been on two dosage reductions.   For me, under 12.5 causes the worse pain in wrists and now fingers.   I know it wrong, but I’ll jump up to 15... and it makes a huge difference 🤗 .   Just had a visit with mother in law.  Diagnosed 6 yrs ago with PMR.  Has had two flare ups, but has been on 5mg for years and is doing great at 84.  She’s my inspiration.  

    It seems like back peddling, however my kids and sanity are worth it.  Just my thoughts, and again, new to this.   Good luck 🍀 

  • celia14153 amkoffee

    So feel for you. I think we set ourselves targets, and the sense of going backwards brings home how long term this is and the struggle to balance pain with medication. We want to be free! However, Pred works, and a few days at a higher dose and the extra support it brings would be brilliant. Subdue the pain, stoke up the energy banks and give yourself a break. It sounds as if you need to re-program and experiment again. Good luck and do tell us how it goes. X

  • EileenH amkoffee

    "Her suggestion was that my pain might be worse because my inflammatory markers are raising"

    The pain is worse because the INFLAMMATION is increasing and leading to the markers rising - the markers are effect, not cause.

    The increased dose of pred would be the same in the case of an inflammatory arthritis flare too - doesn't matter whether it is the PMR or the inflammatory arthritis. And the point of the right dose is to allow a decent quality of life - otherwise you might just as well say you will ditch all your meds and accept the pain. My wrists are the first place a flare starts, I'm never late taking my pred since I take it at night so can't speak to that. But my last 2 flares of PMR have been different from the start and from each other.

    • amkoffee EileenH

      The only time I have been late taking it is when I was in the hospital or rehab where I had to rely on the nurse to dose me and I ended up haveing to ask for it. I now know to keep track on paper of what drugs they give me and at what time. On my own I am NEVER late, In fact my husband wakes me up in the morning before leaving for work, if I'm not already awake, just so that I can take my pills before the pain sets in.

  • BettyE amkoffee

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  • BettyE amkoffee

    One of my least favourite words is "targets". They are a snare and a delusion politically and medically. They just give us the illusion of progress.

    Yesterday I returned to my veg. cage and dug one more bed . Now I'm regretting it. I ache so much that nothing will be achieved today. Pity I don't follow my own advice.

    Don't suffer too much for too long if upping the dose will give you back a bit better life.

  • charles92035 amkoffee


    I know how you feel about increasing your Prednisone dose but I have just gone through the same situation, a Flare, and increased my dose by 5mg. It works, the pain was taken care of and I am back to tapering. I am no expert but I would increase my dose and get rid of the pain. When the 'inflammation' builds up I think it is the only thing we can do to ease the pain. 

  • amkoffee

    Well today I increased my dose by 5 mg in the morning and at 3:30 in the afternoon I saw a hand specialist, and I had no reduction in pain at that time. I'm am still going to continue that extra 5mg for a few more days to see if it improves but the doctor I saw said that I had trigger thumb. I have had trigger finger and had it repaired many years ago. I didn't ever think about it being my thumbs because my thumbs don't get stuck like my finger did. He also said I had osteoarthritis in my thumbs but I already knew that. And he think it's very possible that I have carpal tunnel syndrome so he's sending me to get a nerve conduction study done. Of course both of these conditions can be fixed and I look forward to not having the thumb pain which is the absolute worst part of my hand pain. It does not address the pain I get in my finger joints but that might very well be the PMR or it could be inflammatory arthritis. I really don't know. But one step at a time.

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