flare? | Arthritis Information

Last Sunday I thought I'd discovered walking was the cure for PMR....one week later, I think I am having a flare. freesia2011-06-19 11:46:40Freesia,
So sorry to hear that your having a flare. That burning pain is what sent me back up to 14 mg. It happened when I was down to 9 mg. The "burning" depth of it in the hips is so painful with no relief except to increase the prednisone. Hopefully, 9.5 will do the trick for you. It is frustrating to get so low on your dose and then have to go back up. The lowest I've gotten in over 2 years is 9 mg., no matter how slowly I go.
For me, it's worth it to take a higher dose of prednisone, be able to have some relief and somewhat of a "normal" (what's that?) life....
My rheumy seems to think that the 14 mg. isn't too high. She treats a gentleman that can't get below 15mg. after 2 years. When I compare myself to others on the forum who are on much lower doses in a lot less time, she reminds me that PMR is a bit different for everyone. It's more important to listen to YOUR body and do what it needs you to do.
Hope your feeling better...
Gentle hugs,
JannieJannie, thanks so much. Your words are reassuring! It's weird how much this disease has evolved in my body--this burning sensation in my hips is fairly new. Before, it seemed like my legs were the problem, feeling heavy and clogged for lack of a better word. My hips didn't bother me at all, in fact, when I read that hip soreness, etc, was a symptom it mystified me. It seems like PMR just keeps attacking different areas!

It is worth it to take a higher dose of prednisone and at least be able to live. When I feel like this, I don't want to do anything! I know my pcp doesn't think that 10 mg is a high dose and possibly anything under 20 mg isn't considered a high dose.

Thank you for reminding me that everyone's body is different and you have to listen to your own body. I know that but I guess I've felt some urgency to get off prednisone because of the digestive problems I've had recently.

When I woke up with this last night I started wondering what the heck causes pain like this? I don't understand it. Am I eating the wrong food? etc etc, I go through a whole list of things I think could have caused PMR.

I hope you are having a good day.

freesia
Freesia

So sorry you feel you're having a flare in the symptoms - if you were comfortable at the last dose, do you think that returning to that one might be sufficient for you? It is very difficult after a reduction in the dose to know if increasing pain is caused by increased inflammation or by steroid withdrawal. I tapered very slowly from 1mg to half a mg, taking about 4 weeks to get there and after about 9 days I suddenly felt the stiffness back in my legs. However, I have persevered for the last couple of weeks and it now seems to be improving. Do hope you have a better night.

Hi Celtic,
Maybe I jumped to the conclusion that it was a flare....honestly, I could hardly move my legs and that burning feeling in my hips plus the stiffness and soreness in my legs kept me awake for several hours last night.

It's been a week since I started the reduction to 5.5mg....I thought that steroid withdrawal symptoms occurred very soon after the taper starts; can they start a week later? From your experience, I guess they can! So maybe a week isn't that long... I was just scared I was going into another flare situation. Last time I was down to 5.5 mg, I stayed there for about 3 weeks but I just couldn't stand it and the dr. determined it was a flare.

Celtic, do you remember how long it took for you to "work through" the pred withdrawal pain?

Maybe I made a mistake by going up to 9.5 mg? Darn it freesia2011-06-19 18:05:09Hi freesia,

Whew, that burning sounds like a flare to me, but then I am no expert.

It is really hard on us to know what to do when we do not have ready access to our rheumy. Even a good rheumy cant micromanage our Prednisone. So hard to know what to do.

Prednisone is like a pain pill for us.

Hope you feel better tomorrow. Freesia - that pain you describe does sound horrid especially occurring overnight as it did. It does sound like a flare but what I was wondering was whether just increasing to the last dose at which you felt comfortable may have done the trick.

Following my reduction from 1 to half a mg it took about a week for my increased stiffness to start improving and after about 2 weeks during my daily walk yesterday my legs felt back to normal.

It's true that if steroid withdrawal pain kicks in it normally does so soon after reducing but then improves over the next week or so, whereas a PMR flair can tend to occur more slowly and then gradually worsen. This, however, proved to be the reverse for me recently which could be as a result of the massive percentage decrease in going from 1 to half a mg even though I'd taken four weeks to gradually taper.

A couple of years ago when I reached below 5mg, like you I had a flare (confirmed by very increased inflammatory blood markers) and my rheumy advised me to increase to 10 for a couple of weeks, then reduce to 7.5 alternating with 5 for a couple of weeks and once back on 5 he asked me to stay there for many months - I baulked at this and we compromised on 4-5 months. I then successfully continued the very slow tapering regime (similar to Ragnar's method but even slower) and each time I finally reached the reduced dose, I always stayed there for a couple of months. Looking back now, I feel that my rheumy's advice to stay on 5mgs for such a long time really got the inflammation under control and enabled me to continue with my successful reductions - it is recommended in our guidelines that when below 5mgs we should wait 3 months on each dose before trying the next reduction.

I do hope you get some reassurance from your doctor today and mainly hope that the pain has now disappeared on the higher dose. I talked to my rheumy this morning and she said she probably would have recommended for me to just increase up to my last dosage rather than increase up to 9.5 mg (which is 4 mg higher than what I was taking). However, she said that's okay, if I took 7 mg this morning then stay at 7 mg for a week and then start the taper again.

She particularly wanted to know if the 9.5 mg did bring relief from the burning pain in my hips, and was the pain in both hips? Yes to both questions. But she said if the burning continues at all or comes back, I need to make an appointment to see her. I also mentioned that my shoulders had some of that same burning sensation. It's hard to sort out the pains I get in my neck, back, and arms because of the arthritis and bulging disc, which are separate from the PMR !!!

I feel sort of weird for panicking yesterday---in hindsight, I can see that is what I was doing. I'm just so afraid of another flare--the last one was so upsetting.

Anyhow, thanks, everyone, for your concern and help.

freesia
Freesia - please don't feel "weird for panicking" - it happens to all of us......just part of the confusion that is PMR!

Oh I do so agree with you - when you suffer from a back problem (I have spondylolisthesis - always seem to get things with long names! - it's virtually a slippage forwards towards the base of my spin) it is incredibly difficult to know what is what especially when any pains from a back problems so mimic the pains of PMR.

Do hope the 7mg works - bestest of luck!Hi freesia,

Thanks for the information. I find it odd that PMR attacks our hips and shoulders. I was more used to OA attacking one joint or FM attacking a particular area. Now I have those, plus the PMR going for the hips, shoulders, and overall weakness. Lucky us!

I dont blame you for being scared of another flare. We all are!
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