Increase the steroid dose or use naproxin?

I have a similar problem!  I too have been to the doctors today and I am now increasing the prednisolone by 1mg for starters, then 2 mg if I have still not improved. I was told not to take Naproxin as It will affect my kidneys ( they are not 100% healthy). I thought I was on the way up, but for the past few months have been on the way down! Here we go again.  Hope this helps.

If all you are talking about is "the odd day" - perhaps you need to really sit down and think about what you want.

When you take pred you are started ona dose that will achieve good relief for the vast majority of patients - it is almost certaily more than you need to control the symptoms. Then you reduce to find the lowest dose that achieves control of the symptoms to a level that is acceptable to you. Someone who spends their days just pottering about the house and garden will be able to get away with a relatively lower dose than someone who has to go out to paid work. It is a balance between control of symptoms and side effects - both perceived and unseen long term consequences.

It is NEVER a good idea to take NSAIDs (naproxen and co) alongside pred. The odd dose is probably fine - but I know a lady who ended up in hospital witha gastric bleed after 2 days on ibuprofen and she wasn't even on pred at the time. The vast majority of patients don't find that NSAIDs provide any relief from PMR pain. That probably suggests that if you have occasional pain that is helped by a dose of an ordinary pain-killer it almsot certainly ISN'T PMR. On the other hand, if you have pretty much constant left-over pain - you likely need a slightly higher dose of pred. 

Remember: having PMR doesn't excuse you from other causes of pain. Pred doesn't relieve all sorts of pain. If you have odd days where a thigh muscle is sore - did you overdo it in the few days previously? Did you stand awkwardly? Is there anything else in the picture?

Increasing the dose of pred is not always the answer, nor is it always a good idea. For more chronic PMR-type problems maybe - but look for other causes too.

And a PS: if it is really bursitis, increasing the daily oral dose isn't really the answer. More targeted action, usually with cortisone injections is far more likely to help long term. To really deal with bursitis you would need a very much higher dose over a long period - injections are far better. Acute therapy might be rest and ice.

EileenH - You are a breath of fresh air.  Thank you so much for always having sound knowledgable info. I don't write often but read most posts.  Keep up the great work.