Does Prednisone usually work? | Arthritis Information

Hi all,

I posted earlier regarding my mother who has been diagnosed with Polymyalgia Rheumatica. She has been on prednisone 15 mg per day now for about 3 months and it doesn't seem to be working too well. She is also on mtx, 7.5mg per week. It takes her to mid afternoon before she is able to use her hands properly. I keep wondering if this is the right diagnosis? Prednisone usually works well with this from what I've heard. I know for my RA even 1 mg works. I would appreciate it if anyone can help on this topic as I don't know if it is the wrong medication for her or her depression that is stopping her from coping with this or what?

Thanks

Randy,
One of the ways PMR is diagnosed is the success of prednisone in treating it.
If it isn't working for her at all, I would question the dx.I am certainly NOT a
dr and can't say this with absolute certainty, but it is generally accepted that
if it is PMR, prednisone will help very quickly. Have you or she talked to her
dr about this?

Hi pgr555,

The thing is the doctors keeps saying that in some cases it takes along time to get relief - I can't see this because prednisone is fast acting for things like this. I keep trying to push a second opinion and think I'll keep on pushing.

thanks for your reply.

Kandy, You need to be more specific about your Mom's condition. What was she experiencing before she started pred? Was she expecting total relief? If so, that's not necessarily what happens. The pred makes life tolerable, not always free from pain and stiffness.

I have a suggestion related to not experiencing relief until the afternoon. My experience with pred leads me to believe that it takes several hours after dosing to become effective. For that reason, for a while I would get up about 2 a.m. and take my dose with a glass of milk. By the time I got going in the morning, the pred was working.

The other alternative, which I adopted because I was tired of getting up in the middle of the night, was to split the dose of pred. I would take the majority of it in the morning and a fraction of it at night. My theory is that there was pred still in my system in the morning from that night dose, whereas, if I took all in the morning, 24 hours later I had no pred in my system at all and, in effect, started from scratch each morning.

Some of our members say that splitting the dose like that discourages one's adrenals from getting back to work. That may be true, but to my mind, the first priority is to be able to function somewhat normally and work on reducing the dose of pred gradually after seeing what effect it has on your pain and stiffness. Therefore, I would recommend that you get your Mom to take 10 mg in the morning and 5 at bedtime for a few days and see if that helps. Also tell her that there is no miracle cure other than time, and that some pain and stiffness are to be expected. I have always had hand problems, for example. I can't clinch my fists tightly in the morning and experience some swelling in the fingers. I was tested for RA and it was negative.

Hope that helps, and finally, you might want the doctor to consider treating your Mom's depression as a separate issue. Also, please remember that none of us, to my knowlege, are doctors, and are expressing opinions from our own individual experience. Good luck!

Hi Kandy

I do not have any advise for you but want to tell you to hang in there for your Mom. It is hard enough for you to be dealing with RA yourself let alone helping Mom too. Does she have a rheumatologist or are you dealing with a GP? It might help to get that second opinion you talked about earlier. I think if what Bob says helps to get Mom moving earlier in the day it will be a big help for her mentally. From experience I found it very depressing when I was in pain and unable to do things for myself. Lots of good luck getting this problem solved.

thanks Bob and Pat,

Mum, I think expects to be better than she is too. I just know alot of the time she keeps saying - this is the worse I've ever been. I can't feel her pain and do wander if she does expect total pain free too. She has already been on two doses, morning and night - but I will suggest she wake up alot earlier to take the first dose that may help a little. She is on medication for depression also and I'm still under the impression that this is driving her to feel worse than she would normally feel. I know from my own stuff that it can really get you down but she has suffered depression for many many years.

Before prednisone she could not move her arms from the elbows up at all and could not do things like her hair or reach for things. Now she can move a little but still can't do her hair but by watching her she has more movement than before even if it is painful. So I know it is doing something and I've told her many times - if you weren't on prednisone it may be alot worse again. I have been trying to convince her to go to a rheumatologist - she is under an endocronolgist physician who is good at diagnosing but she needs a rheumatologist for this one.

thanks again for your suggestions and support. I am finding it really hard as I am in pain too, just come off prednisone after 14 years and am having my own difficulties with it but Mum just says - oh but you are 20 years younger than me!! So what Mum - does that mean I deserve it more??? Shouldn't be spiteful but sometimes it does get to me.