Originally Posted by canklecat

Prednisone/prednisolone isn't a pain reliever, not in the sense of opiates. It's primarily a powerful anti-inflammatory. If inflammation is the primary cause of the pain, then sure, prednisone will help. But not all pain is related to inflammation and prednisone won't help.

It's usually prescribed for problems such as acute respiratory inflammation related to severe allergic reactions, bronchitis, pneumonia, pleurisy, COPD, etc. A side effect is pain relief from reducing the inflammation.

And few docs will prescribe prednisone just for pain. It's too risky, especially in repeated refills -- few doctors nowadays will prescribe more than a single course, usually an injection followed by a 4 or 5 day oral course. If that doesn't work they usually won't authorize a refill because it's pointless. At my age -- only 62 but with a dysfunctional thyroid and osteopenia -- my docs are very cautious about corticosteroids/glucocorticoids.

And prednisone can provoke 'roid rage in some folks, especially older men. I've seen it many times, as a caregiver for family members and working in hospitals. My mom was among the few women I've known who reacted badly to prednisone -- she'd become very irritable and irrational. Mom already suffered from bipolar disorder and, for her last decade, dementia, so her mood was always precarious.

I already use Fluticasone nasal inhaler, which barely does anything for my chronic sinus pain. The problem is in the sinuses above the nose and it's so congested the inhaler doesn't reach. Next step is waiting for an ENT referral. I've already had full head scans.

Prednisone and local injections of anti-inflammatories helped me only on three occasions: twice for severe respiratory inflammation; once for shoulder pain after it was broken last year. After two rounds of anti-inflammatory injections and oral prednisone in 2018, my docs wouldn't authorize refills due to the increased risk and low efficacy.