Hi Kate,
I would be very hesitant to make a low dose of Prednisone as an option at this point. As mentioned there are so many other drugs available to help with the joint and muscle pain.
I had to reply to your message because I'm in the same position. However, Prednisone has been a nightmare for me. Apparently I am super sensitive to it. At first, it seemed to give me a lift, as it is a steroid. But they had to keep increasing it and it just didn't work. Eventually, I was put on Methotrexate and that made all the difference in he world. At that time I was on 35 mg of Prednisone. The doctor said I had to get off the Prednisone because it was going to kill me and not the Lupus. I could only reduce it by 1 mg a month or I would get sick. When I got down to 15 mg, I developed diabetes. Eventually I started to reduce the Prednisone again. I got down to 8 mg and then got sick again with pericarditis. I was so sick that the doctors were suggesting that I might have to stay on a small dose of Prednisone. I was going to agree to this until my latest episode. Last week I woke up with excruciating pain in my knees. I have been basically bedridden since then. I have had severe stomach issues as well. Turns out it is from the Prednisone. I was up to 80 mg for the pericarditis. I'm down to 50 mg now, but the doctor said I may be in this condition for several weeks. So, I think for me I have to find a way to get off the Prednisone completely. My sister was on Prednisone for 35 years due to Chrones. Imuran was the only drug that worked for her. She could only reduce it by 1 mg a month or the Chrones would come back. She has been on imuran for a few years now with no problems whatsoever.
I know Prednisone works wonders for some. Short term, there are generally no problems. But they ARE cases like mine that are severe. So again, I would hesitate to choose Prednisone as the choice of drug at this time, especially long term. My choices are limited because I can't take anti-inflammatory medications because I must take Coumadin. When I get through tis crisis, I will most likely try Imuran next.
Hope this helps.
Nutty