What pain relief can I ask for when reducing preds

Everyone is desperate to get off pred, don't think that because we all take it we like it. You have a choice - acccept a high enough dose of pred to get the inflammation under control to start with and then a dose that is high enough to keep it controlled, or accept the pain and disability of PMR until it burns out and goes into remission - which might be 2 years or it might be 10 (I've had PMR for 10 years altogether). In the meantime there will be uncontrolled inflammation in various parts of your body, damaging blood vessels and putting you at higher risk of vascular disorders, and also increases the risk of some forms of cancer. Controlling that inflammation with pred does reduce that risk somewhat, other pain killers won't do that even if they worked for the pain. 

The only way to manage the steroid withdrawal pain is to reduce in very small steps - as we keep saying. The only realistic way to manage PMR is with pred - if there were a reliable drug that did it without the risk of even more side effects they would use it. Methotrexate is touted by some - but the most recent opinion admits it has no real role in PMR. The original work was very ambivalent - one study said it worked to reduce the pred dose, one said it didn't and one didn't know. It doesn't mean you stop taking pred - they are used together. It probably helps in patients who have late onset RA as well as PMR or who have LORA and not PMR, they present similarly and about 1 in 6 patients given a PMR diagnosis has it revised at some point.

I took a small daily dose of Ibuprofen and Paracetamol to try and control my pain in my bedbound days with undiagnosed, therefore untreated, PMR.  It really did nothing to control my pain, but I was advised to take it just to get me to hospital rheumy appointments by ambulance and wheelchair for various scans.  After all those months on Ibuprofen, I was diagnosed with chronic kidney disease - now I can't prove that Ibuprofen was the cause (although the liver and kidneys are a documented risk), equally it might have been the untreated inflammation lurking in my body for such a long time.  Although whatever was ailing me at the time spontaneously and slowly resolved in just under a year, it wasn't to last.  A couple of months later all the pain returned together with additional symptoms, and I was eventually diagnosed with both PMR and GCA and started on 40mgs of Pred.  It is quite likely that because the inflammation of PMR had been allowed to course through my body without treatment during that first horrid year that I eventually succumbed to GCA.  

So you may be wise to ensure that you take sufficient Pred to control your present inflammation rather than add in a painkiller or NSAID such as Ibuprofen.  Having said this, there are a few PMR patients who find that paracetamol has helped them through the first few days following a dosage reduction;  however, there are people on another PMR forum whose stomachs have also been severely affected by Paracetamol.

Like you, I'm sure most of us empathise with the feeling of needing to get of Pred asap.  But remember, untreated inflammation is the enemy, NOT Pred.

Personally, I see the attempts at reduction

more as tests to see if the inflammation is going down and so I am one step closer to it burning out, than as attempts to get off steroids.

Getting to a lower dose then brings the added benefit, hopefully of being a step closer to losing the horrible fat face and neck etc that the 'saviour' has brought me!

I struggled getting from 12 to 11, gave myself another 6 weeks at 12. Now I am going for 11. I took 11 on Sunday and 12 Mon and Tues. Plan to take 12 the rest of the week and have 11 sun and Mon next week and so on. No pain so far, this was not the case last time so I an hopeful that I am improving. Sadly it is in charge, not me.

Hope this helps

Sheila