Advice please

[Jesspa]

Hi

I had major abdominal surgery in 2015. Resulting in a hernia which was repaired in August 2018. This caused a Seroma which I have just recovered from.

I had been off work for 6 months. 9n return to work on reduced hours I found I was in a lot of pain. Neck shoulders arms to elbow. Hips down to thigh also shins. Also very bad pins and needles in hands and difficulty holding things for short lengths of time. Ie phone pen fork.

At first my gp prescribed Vitamin D3. But this did not help. So blood tests showed I had PMR and I'm seeing a rheumatologist on the 25th Feb.

Go put me on prednisalone 15mg. Been 8 days now. Still unbearable pain. But pins and needles not so bad.

Any advice appreciated.

Thank you

[suzy1959]

I think you should have felt more improvement by now. You may not be on enough Pred. to clear the inflammation. Some people need more than 15mgs. at first, say 20 or even 25mgs. If that doesn't work then it probably isn't PMR, although your symptoms do suggest it is. We are told to expect 70% improvement of symptoms with Pred.

[Jesspa in reply to suzy1959]

Thank you

[SheffieldJane]

I am wondering whether your diagnosis is correct. The blood tests will only show inflammation, they can’t show PMR definitively. You should have felt some improvement on 15 mgs even if it wasn’t enough. I believe that a start dose can be anywhere from 25 mgs to 12.5 mgs. At the higher end if this has been going on for some time. I would return to my doctor. The pins and needles concern me too. I don’t know how typical that is of a presenting symptom with PMR. I hope you obtain relief soon!!

[Jesspa in reply to SheffieldJane]

Thank you.

I haven't seen the rheumatologist yet. So see what happens.

[PMRpro Ambassador]

Do ask your GP to let you try 20 or even 25mg if that isn't enough - 15mg is the bottom end of the range for starting dose. Once the existing inflammation that has been stored up is dealt with you should be able to reduce the dose again. Up to 25mg is the recommended starting dose. If 25mg doesn't give you a good relief in a few days it does reduce the likelihood this is PMR - there are other causes of similar symptoms and some don't respond to pred. If 25mg isn't giving about 70% relief - the chances are it isn't PMR and is one thing ruled out.

The pins and needles in your hands are possibly due to carpal tunnel syndrome - which is common alongside PMR.

[Jesspa]

Thank you. I think my gp started me on 15mg so that it didn't worsen and as I haven't seen the specialist yet.

Thank you to all for feedback x

[PMRpro Ambassador in reply to Jesspa]

Yes, maybe - but the pred doesn't stop it worsening - it only manages the inflammation and if it isn't clearing out the existing stuff it will just get worse. It's a bit pointless not taking enough to keep it at least stable with little pain.

[powerwalk]

I've just been searching pins and needles in hands as it is driving me mad in both hands. Did yours go? Or did you find out what it was? Thank you.

[PMRpro Ambassador in reply to powerwalk]

Which fingers?

[powerwalk in reply to PMRpro]

Literally all of my hands. And then like something crawling on them. Tips of fingers too.

[PMRpro Ambassador in reply to powerwalk]

Have you spoken to your GP? It sounds like some form of neuropathy or both carpal tunnel and ulnar nerves being involved.

[powerwalk in reply to PMRpro]

I tried to make appt today. She is away til 10 april. So will hold on. Dont want to go to her stand in. Can you get these in both hands? Is that just coincidence that its the two hands?

[PMRpro Ambassador in reply to powerwalk]

Impossible to say - if you have neck problems I suppose the carpal tunnel/ulnar nerve option is possible. But the neuropathy might well be bilateral.

[powerwalk in reply to PMRpro]

Thank you.