Third day on Predisilone and worse than ever

Hi, I was diagnosed at the beginning of June this year. I started on 15mgs but it took me a week to get relief and I had to up the dose to 25 mgs. I reduced to 20 mgs pretty quickly after that. Since then I have used the slow method of tapering and am on my way to 12.5mgs. The pain around the shoulders at at the base of my neck is still present, although much reduced and I have had an X-ray to check whether there is another cause. Pred can mask symptoms of other problems not directly related to polymyalgia. Hope this helps 

Tks Celia,   So maybe it just needs more time since it's a low dose.  I'm supposed to take 15 mgs for two weeks then drop to 12.5 for another 2 weeks until I get to 10 where I stick until March.  To be honest I thought the relief would be quicker I was really pinning my hopes on going back to work after the christmas holidays but that seems to have gone out the window.

But I don't understand why I feel more pain now than before.

 I think I would prefer any other diagnosis.  Even a cancerous tumour that could be removed and then I could get my life back.......Yeah   Just a little cancerous tumour ........................

I was exactly as you, thinking that maybe I don't have PMR. Also started at 15mg, which is on the low side of the starting range. After about a week or a bit longer, finally pred had "cleared" the backlog and pain subsided.

The rule is that you should be at least 4 weeks on the starting dose ( not two) and then each step above 10mg can be as short as 4 weeks. Below 10 mg you need to follow "DSNS" (slow taper method) to avoid problems. Keep in mind that average length of PMR is 4-6 years.  What dose you need is determined by underlying PMR activity. Pred only manages symptoms, and does not cure anything. If you reduce more then you should, your symptoms will return and you will have to go up in dose to clear the inflammation. 

It’s early days yet!   Some patients find pred takes a time to kick in, others feel amazingly better after just a few hours.  You will learn that we are all different.

There is always someone on here who will listen/advise and try to help you through the next few days/weeks/months.

Good luck and welcome to the club that no-one wanted to join.💐💐

 

Hi Jennifer, I am so sorry about your pain. PMR is difficult to diagnose, it is really a matter of discounting everything else first, although your symptoms do sound very like PMR. Some people do find that 15mg is just not enough to block the initial inflammation, it can depend on your build even. They say you should try up to 25mg. Over that it may be that the pred is sorting out something else and so can be misdiagnosed. 

Did you ever ever try other pain killers over the last three months? If so did they work? PMR tends to not really be helped very well by anything else except pred. 

I agree with the others that you may need a higher dose (up to 25 mg is sometimes needed) or simply more time.  Are you treating yourself like a poorly bunny?  You need to get some rest even if you aren't fatigued.  I didn't feel fatigue either when I was first diagnosed, and was quite active once the pain went away (took a few days to go completely although I felt a little better quite quickly).  But I was also retired which meant I just did what I wanted when I wanted.  It was later that I learned it was wise to take it easy.  I know that people who are still working or have other commitments often have more trouble getting the pain under control.

If all you have is joint pain I personally would be doubtul about a diagnosis of PMR. And if what you have is PMR you would expect at least some improvement in 3 days - not an increase of stiffness. Though as I have already said elsewhere - 15mg is not a high dose, some require 20 or even 25mg to get a result.

However - I'm not impressed by your doctor's instructions. 4 to 6 weeks at 15mg is more normal and speeding down to 10mg will only work for some. If the pain hasn't improved before you are due to reduce - don't do so and ask for a rethink in one way or another.

Hi their, so you have hound the polymyalgia club haha , it took a good 10 days for my prednisalone to start working to take away the very very painful hips , shoulders , arms , some one will be along to help you more on this site , hope your steroids starts to help you soon xxx