Is four days long enough for pain to ease?

After 5 days on 15 mg did not relieve my PMR symptoms very much, my docotr put me on 20 mg.  After about 5 days at that dose, the pain was still present but was greatly reduced.  I have heard from others on this forum that some of us just have to start at a higher dose.  There is also the possiblility that something else is wrong so, if you have not told your doctor about your lack of response, that would probably be a good idea.  

PMR is considered treatable and you should not have to live with constant pain and inflammation.  Good luck!  

Assuming 15 mg was your starting dosage and you did not reduce to that level, I would definitely say that you should not have to wait 4 days for relief.  If you have the right dosage the relief should come within 24 hours, at least it did for me and others on this forum.  The key thing is to be at the right dosage where the pain and inflammation is greatly minimized or non-existent.  I started at an initial dose of 10 mg/day but went up to 15 and then 20mg/day within 3-4 days until I found relief at the 20 mg level.  I would definitely contact your doctor and say your symptoms have not been relieved and he/she should increase your dosage.  Good luck.

Susan, we do occasionally come across people who say that their starting dose took a week or two to work.  Also, there are people for whom 20mg is needed to achieve relief in their symptoms, especially those people who are overweight. I assume you are taking your steroids in one complete dose early in the morning and are having plenty of rest to allow the steroids to do their job. 

I agree entirely that the effective dose should more or less eliminate the pain, or at least the pain that is caused by inflammation (PMR). Because the medical profession doesn't have a clue about PMR (no known cause, no known cure, no known life-style changes that help, only one medication known to ease the symptoms, for which dosage is entirely hit and miss, and of which the many seriously damaging side-effects of long-term use are well known.

Having learned all of that after it was clear that my local internists didn't have a clue, I decided -- arrogantly, no doubt -- that there was no point in seeing a specialist, i.e. a rheumatologist.  What could s/he tell me that I did not already know?  After six month of suffering, I surrendered and at only ten wekks' notice here in the wonderful land of private medicine (the US), I got an appointment, and saw said specialist last week.  Did he tell me anything I did not already know?

Only this.  He agreed with the diagnosis of PMR, and reiterated that prednisonenis the only drug that helps, but he strongly disagrees with the conventional wisdom (CW) about how it should be prescribed.  CW is:  Start as high as you need to, but no higher, typically 25-30 mg and reduce that pretty sharply after one week, holding  at 15 mg for eight or ten weeks, then starting to taper.  If pain returns, go back to 15mg and try tapering some weeks later.  If pain does not return taper to 5mg, stay there for a couple of weeks, then 4, 3, 2, 1, 0, each for two or three weeks, and say goodbye to PMR for keeps.  

This man's disagreement is about doses.  He says the damage caused by LT use of cortisone is being played down, and that all the doses mentioned are too high. He would start at 10mg and go higher only if needed, and his objective would not be to get you off it altogether -- he says it does come back, frequently -- but to get the patient down to 5mg, and then a 2mg maintenance dose for ever and ever and ever.

I was very impressed by him, and he specializes in joint pain.  But the only thing I learned is that his view about the appropriate doses differs from the majority view. As he says, the long-term effects of any steroids are well known.  I hope this is of some interest, or even help.

If you have not had an improvement in your symptoms of somewhere about 70% overall after a week you need to go back to the doctor. Maybe he should try 20mg for a week - but if that doesn't work then he needs to reconsider his diagnosis and send you to a rheumatologist for a proper assessment. There are other things that resemble PMR - and they do not respond to 15-20mg pred.

https://patient.info/forums/discuss/pmr-gca-and-other-website-addresses-35316

Follow this link to a post with a load of other links - the second last one is the Bristol group paper aimed at GPs describing how they approach the diagnosis and management of PMR. It expalins how PMR should respond to a moderate dose of pred - and how other things don't. Take it to your GP and ask him to consider it.