Increase Pred or take Paracetamol or Ibuprofen?

Taking ibuprofen or any other NSAID can cause stomach upset. Combine that with prednisone which can also cause stomach upset and you're asking for some real GI problems. Also it does not work for PMR pain. For whatever reason PMR pain really only response to an anti-inflammatory like prednisone. When I was diagnosed with PMR ( I was 55 also) I was already taking narcotics for lower back pain and yet I still felt all the pain from PMR. If you really don't want to increase your prednisone dosage you might consider trying turmeric and other known anti-inflammatory supplements. If you're not already taking any it would be worth trying it. I tried turmeric myself but it upset my stomach too much.

Hi Jan. I am about your level 6mg after 18months. I am taking half a teaspoon of bicarb of soda or baking powder, in  small glass of water before I go to bed, its supposed to be an antinflammtory  I do feel a lot better after  2 weeks, sometimes I miss a night   give it a try cannot do any harm, I hope. good luck

 

 

As amkoffee says Ibuprofen is contra indicative with Pred and does not work anyway to relieve PMR pain. You can take paracetamol though this also does not help PMR pain but it will help other pain you may have.

Jan, if your pain is PMR NSAIDs will not help. You need more Prednisone to stabilize your inflammation and get it under control. PMR is always there and you need the amount of Prednisone control the inflammation if not the inflammation will get in control and you will need more Prednisone to get it control. I was at 7mg out of control flare and had to go to 30 mg to get relief. Good luck on the rest of your journey. Try to stay positive and smile. ☺️

I think there needs to be a more nuanced discussion about NSAIDs.  Contrary to what is often written in this forum, they are anti-inflammatory (it is in the name) and this will have some effect on the pains of PMR.  However, it is not as effective as Pred and as a substitute would have to be taken in such large doses over a long period of time that the potential side effects would become almost inevitable – acute gastric crisis and increased cardiac risks.

There is a discussion to be had about whether NSAIDs could be used occasionally as a supplement to Pred during tapering.  As the NHS says on its official PMR website:  “Your doctor may prescribe other painkillers, such as paracetomol or NSAIDs, to help relieve your pain and stiffness while your dose of prednisolone is reduced”.   I have occasionally used NSAIDs in this way, and it did eliminate residual PMR pains and relapsing symptoms for the days it was taken.  I have never taken NSAIDs as a long term measure for PMR, even as supplement.  

Prednisolone is also aggravating to the stomach and adding NSAIDs to the mix will make this effect much worse.  Doing so – even occasionally – should only be considered if you are on a protective PPI as well (Omezaprole, Lanzaprole etc), which many of us are anyway.

 As so much with PMR, research into these matters is weak.  It would be nice to know more from clinical research and trials.

 At one stage when I was getting down to lower doses ( around 7 ) my GP asked me to try Paracetamol to see if it helped my pain and stiffness, his reasoning being that maybe the pain was down to my long term OA. and if the Paracetamol controlled it then we could probably assume that it was no longer PMR. 

Like you, I found a marginal improvement stiffness wise. but the pain remained. I tried for a week but  had to stop because, unlike the rest of the world, it turns out I must not take Paracetamol which is another story. So back to just the Pred. and eventually ( five years ) I got to zero.

It doesn't sound as though it's giving you much help and four weeks is giving it a good chance to see. Four weeks is also a long time to be in such discomfort.. If it were me I'd go back to the Pred. dose where I was last comfortable. 7 is quite a low dose and maybe not enough to give you hamster face. 

You are not reducing relentlessly to zero: you are looking for the lowest dose that manages the inflammation as well as the starting dose did. And at a guess you have found it: 7mg, possibly even 6.5mg. If you ignore this now you run the risk of letting it develop into a proper flare as the inflammation builds up again, like a dripping tap filling a bucket, and then you will have to go back to a considerably higher dose to get it under control

It doesn;t matter how slowly you reduce - you will not get below that dose which is just enough to manage the daily dose of inflammation,