Pain on reduction
Posted , 8 users are following.
Last week, my dosage of Prednisolone was reduced fron 7mgs to 6mgs and all was well for three days. I was then hit with a return of the pain in my hips and thighs and could hardly bear to move. However, the pain is not as bad today and I was wondering if this because my body is getting used to the lower dose, although this has never happened before on my trip down from a starter of 15mgs. Anyone else experienced similar?
0 likes, 40 replies
BettyE
Posted
Yes, I have had this at various reductions, most recently from 8 to 7.5. It did right itself and my GP said he thought he'd give it a week to settle before increasing the dose.
According to my schedule which is not written in stone, I should have reduced to7 last Wed. but have delayed as my hip and thigh ( only one side so what about the bilateral pain that is mentioned so often. Mine is just a moveable feast as they say.)
The advice we are always given by so many on here is to listen to our bodies though, I must say, I often have firm words with mine and sometimes it listens!
God luck for a pain free Sunday. BettyE
madgewildfire
Posted
Lizzie_Ellen
Posted
I've been very, very lucky and gone through a text-book reduction (so far) with the exception of 7mgs to 6mgs. I had about 6 days of what I call 'background' pain when I first dropped to 6mgs. I decided to work through it because it wasn't too bad (although I would have adjusted if it had been too bad) and luckily its all settled down again. I've found 6mgs to 5mgs absolutely fine even though the percentage is slightly higher. Strange animal this PMR!! Hope you're soon able to get back to your reduction regime, pain free.
Lizzie Ellen
EileenH
Posted
Good to hear your reduction is going fairly well - but did you just drop from 7mg every day to 6mg every day? There has been a lot of discussion about reducing over the past few months which I'm sure you'll have seen.
I posted last weekend about a statement I found in a rheumatology medical textbook/publication that no drop should be more than 10% of the current dose and 7 to six is more in the region of 15% so a better plan would be alternating 7 one day and 6 the next for a few weeks. There are some people on this forum who would drop to 6 one day the first week, 2 the second and so on, distributing the days with the lower dose evenly across the week, others would even take 2 weeks at each drop of an extra day.
The other thing I'd say is that it was decided in a thread a bit back that pain that starts after the drop but then eases over time is most likely to be the steroid withdrawal but pain that starts and then steadily increases is more likely to be the dose being too low or the drop too fast. It was felt that giving it a couple of weeks was a fair trial - if you're still in pain then, go back up to the last dose you were comfortable at and then try again, with a smaller drop if possible or using the very slow drop pattern I mentioned before. If the pain has gone - you've succeeded with this drop! Then give it a good gap to settle down before the next attempt.
And remember - the weather is changing quite dramatically at present and that may have an effect on some people!
Good luck,
EileenH
Lizzie_Ellen
Posted
I'm on the reduction method Eileen mentioned, 1mg over a period of 7 weeks ie: drop to the lower dose once in the first week, twice in the second and so on. And even on this slow reduction I did feel a bit of a punch, as I mentioned before, between 7mgs and 6mgs. As I am now on 5mgs :wow: I'm thinking of taking the advice from several posters to take it a bit slower. I may go with Eileen's comment and take 2 weeks at each drop of an extra day. Good luck.
Lizzie Ellen
madgewildfire
Posted
EileenH
Posted
Just occurs to me - the 7mg/day dose is around the region of \"what the body produces normally\" level. There is no real solid evidence that I can find for the claims made that at this point you should have no side-effects and also that this is the point at which the adrenals kick back in so stopping from here on in should not be too difficult. However - if that is so, this might be the reason this point poses a problem for many. It is the adrenals having to \"fire-up\" again (putting it crudely, it's rather more complex than that!) and maybe being a bit behind-hand that cause the trouble. A long slow and steady reduction, perhaps taking it easier than usual (as MrsK always recommends) and holding out against the discomfort as long as it isn't too persistant may be the answer.
Just a thought.
cheers from snowy Italy - the view from my computer is quite pretty today! (not in the village, just up the hill)
EileenH
Lizzie_Ellen
Posted
Lizzie Ellen
EileenH
Posted
EileenH
mrs_k
Posted
I wonder do the medics ever test adrenal function when they think it has kicked in?
Because I did not like taking the white ones, I went from 7.5mg to 5mg took well over a month on a sort of alternate day programme. It worked for me, but that is GCA and not PMR.
I skipped 7mg to 6mg (naughty) went, 7,7,5,7,7,5 the first week, then 7,5,5 etc
I am now stuck on 3mg, was going to take another drop, but now have Vit D deficit (Yes, I asked specifically for the test again, as I was experiencing lots of muscle pain, but no stiffness - so argued it could not be PMR after this length of time).
Everybody over 60, irrespective of health problems, should ask for the Vit D test. Got that piece of advice from impeccable sources.
Over to you Eileen to explain why.
mrs_k
Posted
meant to type 7.5mg then 5mg - but you all get the idea.
Sorry
MrsO-UK_Surrey
Posted
Just came across a site which gives what I thought was the best write-up yet I've seen on the adrenal glands and tapering steroids and thought you may be interested. Have a look at 'Churg Strauss Syndrome and Tapering Steroids' and click on the 3rd link '.........About CSSA. Different disease but also auto immune and also treated with steroids. I haven't read it all yet but having just read all your posts on the subject I got all excited and wanted to share it with you! :lol:
MrsO
EileenH
Posted
EileenH
MrsO-UK_Surrey
Posted
Just been for a little walk and it's very cold but, unlike you, no snow here yet thank goodness but the sheepskin-lined boots are on order - don't want a repeat of last winter's chillblains. :snowball:
MrsO
Mrs_G
Posted
I am assuming that the first time I had PMR my adrenal glands had no trouble starting work again as after a year starting on 20mg I was down to 1mg for my final year
I am eating all the right things which I did before but now I have cut out any extras and have tried to increase the protein mainly fish and cut out the carbs and have lost a few pounds and am feeling more active
My old horse now has an illness where her adrenal glands are over producing cortisol !!!!!!!!!!! so I am going from PMR to Veterinary websites and I will be getting confused as to what I should be doing for me and her !! She is on a human drug just to make things even more confusing
Just hoping we dont have such a bad winter as last year even though we live in the sunny south !!
Best wishes to all
Mrs G