Realistic Expectations from Pred

Thanks for the common sense! I'm getting the picture that the steroids suppress pain if you're lucky, and that you get to the lowest maintenance dose that works because of the steroid side effects - and just sometimes the polymyalgia clears up of it's own accord. We can't do anything to help the actual healing process. Is that about right?

It's not a barrel of laughs but my heart goes out to youngsters who get this thing. I'm senior and lucky still to be here to have it! Thanks for the info.

All depends what you describe as a senior - the vast majority of PMR patients are over 50. Some doctors refuse to consider it can happen younger (of course it can) and some even won't diagnose it in under 65s!

Celia, for me the first dose of prednisolone was a miracle. I believe that prednisolone acts a little faster than prednisone, but I went from debilitating stiffness in shoulders and hips to complete freedom. I was playing golf 2 hours after the first dose, not very good, but I could pick up the ball from the ground as I had not been able in many months! Then my gp put me on 10mg prednisone and sent me to the rheumy. I did not slow down as I should have. My two daughters were both moving last summer and I did way too much. Pain and stiffness returned, fever, headache, going to 15mg and then 20mg for 4 weeks. Then I got eye trouble and was diagnosed with GCA. Put on 60mg, symptoms gone, but fatigue, sweatiness took months to improve. Now I am slowly getting better, still on 22.5mg pred, using Eileen's DSNS method. I hope to be off pred by the end of this year.

Good luck with the prednisone. Hope you will have minimal side effects, like me. But both the disease and the reaction to prednisone is very different for each of us.

It sounds as if you've had a rough time and certainly there's a timely warning about doing too much because the symptoms reduce. Our heads and habits are always in advance of our bodies so I shall take note of the pacing and resting advice. Glad you're sorting things out, hope it all continues well. 

"Our heads and habits are always in advance of our bodies so I shall take note of the pacing and resting advice."

That is one of the first and important lessons to learn - the second is the acceptance that this is the way it is and learning to chance your ways of doing things to accommodate the limitations. But EVERYONE forgets or thinks "it'll be fine" at some point. If you are sensible it will be once - some people seem to struggle to learn!

Prednisolone works faster simply because it is absorbed in the active form. Prednisone is inactive until it has been processed by the liver to form prednisolone. The difference is only about an hour or so for most people. But everyone is different in the form of their illness - and bursitis and tenosynovitis take longer to respond than muscle problems. And people absorb different amounts of the dose they are given - someone taking 10mg may effectively get 9mg or they may only get 5mg. That is why they start with a dose that is thought to be enough for anyone and then you reduce to find "your" dose. There are other factors though in the activity of the illness. Too many doctors for get how much difference there might be between different patients.