Three Times Dreaded Prednisone Taper Dodged!
It didn’t take long after becoming an official RA (rheumatoid arthritis) patient to dread the prednisone taper. This speaks to my love-hate relationship with the medication! I love it because it relieves the acute pain and swelling in my joints during an arthritic flare, but I hate the side effects (as outlined by Dr. Theodore Fields, Attending Physician at Weill Cornell Medical College) and how it messes with my body systems. I had three situations occur last year that could have called for a prednisone taper. This is based on the level of pain, swelling and warmth of my joints.
The first situation involved my feet. The pain and swelling in both feet got to the level I couldn’t walk. If I tried standing, the pain level was so high I had to sit right back down. The initial feet episode resulted in my taking a prednisone taper. It did as it does bringing down the pain and swelling, but I “held my nose” taking it. When this pain and swelling in my feet popped up again a few months later, it was suggested we look into the problem more closely I was referred to my podiatrist. He fit me with shoe inserts, recommended taking Aleve or Advil for a few days, then sent me on my way. In addition to my arthritis, I have plantar fasciitis. I never go bare foot, even at home. I wear sandals or a shoe with arch support always. I wear shoes with a big toe box to give my toes room not to be squeezed. I also wear my shoe inserts. This has resolved the problem, at least for now!
The second tricky situation involved my jaw. I was unable to open my mouth without great pain. I’d been aware I was at risk for TMJ (temporomandibular joint) because I grind my teeth while sleeping. I have a mouth guard for this, I just wasn’t compliant wearing it. I paid the price for that! I went on a liquid diet for a day, then I ate a soft diet (soft foods that don’t require chewing such as applesauce) for several more days. I took Aleve while the pain was acute. Problem resolved without the dreaded prednisone taper! (Oh, I am compliant with my mouth guard after that horrible experience.)
The third tricky situation involved my neck and shoulder. This particular pain presents uniquely in me. It makes me nauseated and is probably the worst of all pains. I saw the orthopedic surgeon to rule out a rotator cuff issue. I then spent the next few months going to physical therapy. The theory was my nerves weren’t getting properly oxygenated due to fatigue and lack of movement in the area. Working at the computer late at night resulted in not getting to bed on time. Perhaps my exhaustion played into sleep positions causing a nerve or two to get pinched. Hard to tell, but the pain was through-the-roof! It seemed to set up a chain reaction of sorts because I’d try to protect the painful spot while infringing on another area. I was a mess. By going to therapy and learning exercises to strengthen the muscles in my neck and upper back, this scenario has not reoccured. The physical therapist has a theory the movement also keeps the nerves oxygenated. Again, I was able to dodge the dreaded prednisone taper!
The message I want to convey is to look beyond the RA when a new acute pain occurs. I was thinking all these awful pains were due to my rheumatoid arthritis, and they are all probably related, but the resolution may be something other than the prednisone taper. I certainly found that out. It may be the pharmacist in me, but I really do not like to take prednisone if I can help it! Now that is Arthritis Wisdom!
I’d love to hear of situations you were able to dodge the prednisone taper! Take good care. XOXO Cathy