New back pain

[jacdo]

Morning everyone, I'm after a bit of advice if possible.

I have been following my rheumy's advice when I saw him in August, and tapering down and I'm now on 5mg. I did tell him that I had started to get some stiffness back but he still wanted me to taper (I was on 7 mg then). He said in his letter that I have "likely PMR, background psoriasis" so I think perhaps maybe he wants me to taper to see what happens.

My main concern now is the pain I have at the top of my spine just below my neck. It is a constant pain and very sore and tender to touch, like a bruise but there is nothing to see and no obvious swelling.

The other new pain is the middle finger and thumb of my left hand. My finger is very stiff but not particularly swollen. My thumb is very painful and I am having trouble using it to do anything. I can see that the bone looks more prominent but not really obvious.

I wondered whether these are PMR symptoms and whether anyone else has them. I have chased up my next appointment which should be every 3 months and been told I'm "on the list'.

Thanks in advance for any advice.

[piglette]

Hi jacdo it sounds like your thumb problem is osteoarthritis, I have the same problem. Impossible to open jars!

[jacdo in reply to piglette]

Yes I know what you mean!

[Pongo13]

I have same neck pain so will be watching your replies. Also same prob with hand but that is not a cause for concern as pred has masked that pain.

[PMRpro Ambassador]

"I can see that the bone looks more prominent" - do you mean the middle joint? I have small Heberden's nodes that make that thumb joint and the distal joint of the index finger more apparent. They were sore originally but no longer hurt.

If you have a background of psoriasis he may be bearing psoriatic arthritis in mind. PMR and PsA can present almost identically and it is a favourite either/or for many rheumies.

[jacdo in reply to PMRpro]

Thanks for your reply. It is the bone at the base of my thumb so trying to hold anything with my left hand is getting really difficult. I’m pretty sure that I will be offered an injection as that was on offer for my hip and my arm/ shoulder when they were playing up.

My rheumy stated that these were “likely to be a localised pathology rather than part of the systemic disease”. I declined the injection and I think all of the symptoms should be looked at as a whole but I’ll wait and see what happens at my next appointment.

Do you think the pain at the top of my spine is related to PMR? To be honest I agree with you and think he is trying to decide between PMR and PsA. My psoriasis is having a break out on my scalp at the moment, must be coming out in sympathy 😂.

[PMRpro Ambassador in reply to jacdo]

The joints at the base of my thumb often hurt when I am flaring and were painful in early PMR making holding things difficult. He may be right - but I don't think so. Too many doctors insist these joint pains aren't PMR. I also get sore spots along my spine and at the top was one of them. Is it PMR? I don't know - but it does tend to mirror it.