Increasing Pred dose

Posted , 7 users are following.

Hi everyone, Eileen hoping you see this, havent been here in a while due to family illness but really need some advice. Have been at 5 mil of pred for over three months, assuming my body is trying to get back to normal and maybe thats why the pain is so bad. Have been tolerating the pain but for over a week now my groin is agonizing, my entire body is aching and my upper back behind shoulders so tender that I can barely get moving in the morning. It eases a little during the afternoon but still painful.

My question is can I automatically go up to the dose where I was pain free which was 15 mil just to test it and see if the pain all goes away within a day or even hours and then go immediately back down to the 5 mil, or do I have to increase in 1 mil increments to see where I need to be. Im so confused because I was planning on staying here at the 5 mil for several more months but dont think I can continue with the pain.

The good news is that at 5 mil the dry eyes seem to have gotten better, I lost the chipmonk cheeks which I never minded and the increased appetite has eased up but all the pain has returned so not sure which is the lesser of the evil.

Yesterday I was limping due to my groin hurting so bad, xrays showed its not my hips.

Thank you,

Sharon

0 likes, 13 replies

13 Replies

  • Posted

    "xrays showed its not my hips" - yes but they won't show if it is trochanteric bursitis! The best thing for that would be a steroid injection.

    If you have pain as you reduce the dose - then there is something not right, you have overstepped the mark with reduction and if you ignore it all that will happen is a flare - and eventually you will be as bad as you were originally.

    But yes - you can take 15mg for just a few days and then drop back. But 5mg is obviously not enough so I wouldn't go all the way back to 5mg.

    • Posted

      Thank you Eileen, I will mention what you said about the injection, its odd because the pain is exactly the same in both left & right groin, I will take the 15 mil to see what happens, if all of the pains go away then that should prove its the PMR correct? And then I will stay at the 15 mil for a while and slowly reduce by 1 mil increments.

      If the pain remains I will again ask Dr for a shot.

      As always,

      Thank you!

    • Posted

      If it goes it will show it is probably "simple" PMR - but oral pred takes some time to sort out hip bursitis. I was on 15mg for a few months before I realised my hip pain was going. But go it did...

    • Posted

      This is such a wait and see game.......I just know I cannot live another day with this pain. I remember 16 months ago having the exact same pain, all over and when I was started on the 20 mil I was a new person, felt so good and if this happens again I will be so happy, the few times I was increased due to the GCA I was also feeling so good but once I got below the 15 boy Ive never been the same and havent felt good for so long. Its not worth this pain just to be on a lower dose.
    • Posted

      "Its not worth this pain just to be on a lower dose."

      Exactly.

  • Posted

    I want to jump in the discussion, because I have problems with me left hip joint area, sometimes better sometimes worse. It also clicks when I circle my leg. I stretch on daily base, also my hip flexors daily, because they tighten up easily. After sitting and getting up, I need some steps to walk smoother. External rotation is restricted on the left leg. 

    I am on 1.5mg DSNS and feel pretty good right now.

    Do I need an x-ray or what do you think could it be most likely?

    I appreciate any respond!

    • Posted

      Something to ask a physiotherapist I think. The other thing that comes to mind, since you mention hip stiffness, is that you have got to a slightly too low dose to manage the PMR.
    • Posted

      Hi Magy, have you had an X-ray if your hip is clicking and you have restriction on external rotation? 
    • Posted

      No x-ray so far. Yes, restriction in external rotation.
    • Posted

      The DSNS I am following since my flare up in January went very good. My rheum wants to go faster- 1 mg/ month. 

      I am feeling the stiffness at the hamstring attachment and between the femoral head and ischial tuberosity, not all around the hip. It's probably the fascia and more on the left side. The clicking and external rotation restrictions is in the left hip joint.

  • Posted

    My Rheumy and I do not agree, but I will not reduce my Phed while in any pain, two weeks pain free, next step down. I hate the Phed side effects, but they are much better than riding around in a wheelchair, give me the Phed! Nice and SLOW!
  • Posted

    Since bursitis has been brought up in this thread I have a general question for you Eileen. I was diagnosed with bursitis in one of my hips before I ever had PMR. I was treated with meloxicam and given physical therapy and it doesn't normally bother me anymore. But my question is does bursitis heal and go away or is it always there?

    • Posted

      I think it depends on the cause really. If it is due to infection, injury or biomechanics (gait problems) then you could aim for a cure once that cause has been resolved. If it is due to overuse and that can't be changed significantly (you can't stop walking altogether!) or autoimmune disorders then it is a bit less likely.

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