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Pmr relapse with normal crp and esr

Started at 40mg Prednisone about a year ago for PMR.  Had classic pains and elevated crp and esr.  Got down, over a year of tapering to 2.0 mg pred. Experienced my first flair (pain) last week and went to doctor.  Crp and esr are normal, but I am experiencing all the physical symptoms of PMR.  Does this sound right?


19 Replies

  • richard07199

    Richard, your rate of tapering, might be too fast. I was at. 30 mg a year ago, currently on 7 tapering to 6.5. CRP & ESR do not always paint a clear picture, they react to inflammation in the body, some time my are high, but not always. If the pain is reduced with Pred and was the same pain you had before, it probably PMR again. Listen to your body! Think positive and try to smile.☺️

  • richard07199

    It may well be - in some people still on pred the inflammatory markers do not rise again even with symptoms or may lag well behind the symptoms appearing. Symptoms should always trump blood markers, they are only a supporting piece of information and about 1 in 5 patients don't have raised markers before diagnosis.

    As Mich says, tapering from 40mg (which is a high starting dose for PMR, it is a GCA dose) to 2mg in just over a year is very fast. PMR rarely burns out in under 2 years - less than 1 in 5 are that lucky. It is likely your PMR is stilla ctive and you have reduced a bit too far to control the inflammation being created every day. You will need under 5mg, all being well, but you do need to go back up a bit.

  • I have a procedural question rather than a medical one.

    On the top right side of this forum page there is a green rectangle saying Follow This Discussion.  One’s instinct is to click on that rectangle if you wish to follow this discussion.

    When you click in that prompt, you get a red rectangle saying Unfollow This Discussion.

    At that point are you following the discussion or not following the discussion?

  • Thank you Michdonn and Eileen.  I still don’t understand.  Maybe the pred is affecting my cognative skills (smile).  Let me put the question another way... At the top of my page right now there is a red rectangle saying Unfollow This Discussion.  Am I following the discussion or not.

    Thanks for your patience with an obvious slow learner.


    • richard07199

      Hi Richard, I always love the ocean, and enjoyed the winter in New Hampshire skiing. We talked about having a little place in both locations. Then our daughter had failed back surgery, the doctors in Boston advised the Southwest. My wife had gone to school here in Los Alamos, so we relocated here. I love the mountains and really have been so busy I haven't missed the ocean. I do miss the great food that is available in the Northeast. But our daughter is doing much better and once again is able to live on her own, so life is good! ☺️


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