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Prednisone and ?'s

  • By mamadee

    My rheum. put me on a 15 day course of 10 mg. Prednisone. 3 pills for 5 days, 2 pills for 5 days, and then 1 pill for 5 days.

    Question: at this dose how long might I expect to notice improvement in symptoms, if it’s going to help? I know it’s not a high dose, but it tends to make me not sleep and get reallllly cranky. So I think she started lowish.

    Also……does prednisone work better for rheumatoid arthritis or osteo?

    My doc. suspects sero-neg. RA, based on symptoms and x-rays. She said I had joint damage in my feet, worse in my baby toes and in my hips. She mentioned bone erosion and something about tiny holes…..not sure what the porous part means. She said the pred. was sort of a trial….if it helps, it would be another piece of the puzzle.

    I’ve only taken one dose, but after a day, don’t feel any improvement. Might it take a few days to help?

    What if it doesn’t help? Does this suggest it isn’t an inflammatory condition? I believe bone erosion suggests RA more than OA, isn’t that right?

    I’m scared it’s going to help…….I”m scared it’s not going to help. Either way, I’m not sure exactly what it means.

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  • By ktinflorida

    You should start to feel it in 48 to 72 hours. Three pills of 10 mg each is 30 mg. From what I know, that isn’t a low dose for RA purposes. They use higher doses, but usually for other stuff.

    With your porous bones, I would be surprised if they use much prednisone on you since it makes bones even weaker. My x-rays show errosions too and I was told it was due to RA, not OA too.

    It sounds like this second Rheumatologist is doing normal stuff, it just isn’t fun to get an RA diagnosis. They could also end up tweaking the diagnosis to something like Undifferentiated Connective Tissue Disease or Mixed Connective Tissue Disease from sero-negative RA. All that stuff gets muddled together and is basically treated the same way.

    Hang in there.

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  • By mamadee

    Thanks ktinflorida,

    I know there are lots of different things in the auto-immune realm.

    If it wasn’t RA for certain, but maybe something in the connective tissue disease or something else, would there be a difference in how it responds to prednisone?

    I’m probably getting ahead of myself, but I’m scared that it won’t help at all and then I’ll be back to square one…..or maybe square two. lol.

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  • By ktinflorida

    No, I think anything autoimmune responds to prednisone. I know both Mixed Connective Tissue Disease and Undifferentiated Connective Tissue Disease does. Lupus does and Scleroderma does. I even think Guillain-Barre does. The prednisone will confirm autoimmune, I think. I don’t know if OA responds to prednisone. That might be the experiment they are running.

    It is understandable to be scared. You have a long road in front of you, but it sounds like you found the right doctor and you just have to take it one step at a time.

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  • By Monica Y. Sengupta Moderator

    Hey mamadee, thanks for your question!! Trust me, you’re definitely not the only one in our community that is wary of Prednisone and other corticosteroids. I thought these articles might be of intrest to you: https://rheumatoidarthritis.net/treatment/steroids/ https://rheumatoidarthritis.net/living/youve-got-to-lovehate-prednisone/

    From my experience, steroids work relatively quickly but you still have to give them time. Medications work at different speeds and in different ways for everyone. ktinflorida, thank you so much for your input! It is much appreciated.

    mamadee, please continue to speak with your rheumatologist about your concerns. It sounds like she’s a great physician who will work with you!

    Please reach out whenever you need to. A new diagnosis with new powerful medications is extremely daunting. We’re here if you ever need to talk! Thinking of you, Monica (RheumatoidArthritis.net Team)

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  • By mamadee

    Thank you Monica!

    I am wary of prednisone, considering especially, that I have osteopenia. I agreed to this short course, because I really wanted it as a diagnostic tool, given my neg. bloodwork so far.

    It’s been about 72 hours now…..and it’s pretty interesting. The 2nd day I woke up amazed. I straightened my arms before getting out of bed and NO stiffness or pain! I walked to the bathroom like a normal person, with NO stiffness or pain. Feet felt great.

    Now, as the day goes on, I do notice more pain in my big toes and knees and one hip., but I’d say it is better. I don’t know if that means I could also have OA going on, or just the prednisone can’t take all the aches and pains away all day. Hips maybe a bit more improvement, as I couldn’t do any of the PT exercises without pain in my hips and leg and now I can…and have more range of motion. My big toes seem to be the last holdout, don’t know if they’ll ever have the same improvement…nothing seems to ever help them!

    So, so far, I’d say there is some improvement overall, but definite improvement in the first morning pain and stiffness.

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  • By mamadee

    So to update….

    day four of prednisone. My toes have now responded as well. I mean…..it’s not all gone, but much better. I even got on the elliptical machine for the first time in a week or two……my knees felt like somebody oiled them. So weird. No pain and smoother? If that makes sense? I could still hear the crackling, but nothing hurt! Toes felt better too, even after exercise.

    So it seems to be helping. Not a cure all, but much better!

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  • By mamadee

    Also,

    forgot to ask……..do they use prednisone for osteoarthritis flares? I know this was a test of sorts to see how well I respond to it. And four days in, I feel pretty good.

    But I just read an article today that they do sometimes use oral steroids for osteo? So I am somewhat confused. I guess it’s just one piece of the puzzle……maybe you are more likely to have a good response if your arthritis is inflammatory in nature?

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