I've had PMR for 3.5 years now and have been reducing slowing from 20 mg without any major flairs. I've had pains here and there and exhaustion, which went away, but nothing major. I'm on 4 mg Pred and I've had wrist pain for about 3 months. It didn't hurt too much in the beginning and it was on the pinkie side but in the last 4 weeks it has gotten really bad and my whole hand swells and hurts. I have no other issues other than PMR and the swelling in my hand has been confirmed to be tendonitis by the rheumy through an ultrasound. Xrays found no arthritis/ no bone issues. Last week I was given 21 tablets of Methylprednisolone for 6 days. (6 pills the 1st day, 5 pills the second, 4 pills the 3rd, 3 pills the 4th, 2 pills the 5th and 1 pill the 6th.) I was pain free the whole week but 2 days after finishing the Methylprednisolone the swelling/pain came back. Right now, I can't even grip anything, barely type. A few months ago, the rheumy wanted to put me on methotrexate to help with Pred reduction, which I refused. Now, she wants to do that again. What do I do? I feel like I've been progressing really well with the reduction but she thinks it's too slow. I don't want another medication with its own side effects. My knees sometimes bother me when I go up the stais but other that and my hand I'm pain free. What do you think I should do? You opinions are greatly appreciated.
Painful and swollen hand: I've had PMR for 3.... - PMRGCAuk
Painful and swollen hand
I would refuse point blank - see the argument in this thread:
healthunlocked.com/pmrgcauk...
It all applies - exactly the same. If you were stuck at 14mg it would be a different thing. You are at 4mg - a tiny dose with no adverse effects according to someone who has forgotten more about PMR than yours has probably ever known. And PMR can last far longer than 3.5 years - no hurry.
I knew you would say that! 
What should I request for the painful hand? Since it's localized, would a cortisone shot do? I see no point in increasing the Pred yet.
There are downsides to a cortisone shot for tendonitis. Too many can weaken the tendon and cause more trouble.
Rest and icing is the first approach really, possibly a wrist splint
verywellhealth.com/wrist-te...
sports-health.com/sports-in...
The second is very comprehensive.
Thank you!!!!
Agree with Pro , if MethylP helped, it is clearly inflammation that needs time to reduce and some rest and rotation to help this to happen .
Getting a wrist ice / heat pack that can go in the freezer or micro depending on which temperature you feel you need at the time is helpful , you wear it for about twenty minutes a time .
Some compression wrist bands of fingerless compression gloves rather than full braces give the additional support while still allowing some use of the muscle to prevent weakness growing.
Increasing the amount of B vitamins , Omega 3 , Magnesium and Zinc and Vitamin C in your diet and through supplements help these joint and tendon issues from within.
Added inflammation means increasing your fluid intake too.
As , does increasing your intake of oily fish and lean meat and eggs , helping increase the collagen available to aid repair.
Slow moving finger exercises and gentle stretching of the fingers and hand with wrist rotations every few hours stop the tendon tightening while inflamed .
Using a cooling cream like Flexiseq or Pernaton Gel or Dermacool in the morning and afternoon and a warming cream at night help too.
Keep your affected lower arm raised on a pillow at night , it helps reduce the pressure on the tendons in the wrist and arm and helps the joint relax more.
( Today's new tip from my physio for all forms of added joint pain or feeling of strain during stretching and exercising too !!)
If you work at a desk , on a computer or doing art or crafts , in future , use a wrist pillow to prevent extra tendon strain .
Rather than helping reduce the tendonitis , reducing Pred would slow down the healing process at the moment .
It would be worthwhile asking if there is another option for you like another week of Methylprednisolone or other pain killers / antiinflammatory while it continues would be a better answer just now.
Discussions on any other major drug changes should be left until you have got the current issue under control first .
You can make you choices with more consideration and in a more calm , logical way when you aren't feeling forced into it by a new injury or pain anxiety.
Perhaps , pointing this fact out to your GP or Rheumy may give them a bit more enthusiasm to help solve the tendonitis as soon as possible , when they know you are willing to consider all your options after it has resolved.
Take care and I hope it improves soon.
Very well said Blearyeyed! I guess I need to be a little diplomatic with my doctor as to not to upset her too much. After all, I still need her to renew the Pred prescription :). I will try everything you suggested, it sounds like a plan. Funny, I already started sleeping with my arm on a pillow and this morning I felt an improvement. I try to keep it up (above the heart) as much as possible. I can understand a change of meds if I didn't improve but I'm feeling better and stronger little by little. I had my appointment with the rheumy in May and I was so happy and excited, I had lowered Pred to 5 mg and felt really good and planned on reducing. Instead she started suggesting Methotrexate. I walked out of there so disappointed! Thank you so much!
I would have walked out - period!
I ignored their reaction, refused the Methotrexate and went home and started looking for another doctor. Also, I continued with the reduction. I just don't want to go to another doctor who's worse, so I'm taking my time finding one. As I said, at this point I seem to need them to renew my prescription.
Yes, good idea to try mechanical means to deal with wrist pain. I'm having similar, I think, problems with my upper arms, and I just know it's not PMR, although can be very painful. Physio helps to some extent but I'm afraid it's going to be a condition I have to manage until I can finally bid my (low dose like you) pred goodbye. And I agree, anything below 5 mg your doctor should actually be very pleased with you and let you continue to taper as and when you feel ready. All the best!
Me: 15 mg pred June 2015, currently (Sept 2019) 1.5 mg.
The latest scholarly article says Methotrexate should only be given if there is a second relapse. You were correct to refuse.
I had several bouts with swollen hands...was told it was carpal tunnel...went to PT..after 4 sessions, wasn’t helping. What did help from the PT was the cold and warm bath therapy (like in a two sided sink)......always start with cold and end with cold...you can look the therapy up on the Web. I also wore a splint that sometimes helped at night......but was almost in tears some days. It went away after about a month. Then it recurred close to the end of my taper....just out of the blue. Didn’t last long...was gone in about a week. I found on this forum that magnesium might help...I took it from then on, and still take one a day. Haven’t had any problem since I’ve been off prednisone. I really think it is a result of the PMR...Good luck. I personally wouldn’t add any meds or therapy.
I really think it's the result of PMR too even though my rheumy disagrees! PT made it swell worse and yes, hot and cold seems to work for me too. It's very painful and it's hard not use the hand for even a few days because I'm self employed. I will take this week and try not to use it at all. I will also be looking for a new doctor since this one seems to have run out of ideas, other than throwing new meds at me. Congratulations on being off of Pred, may it stay that way. Thank you for your opinion.
Following this with interest as I’m also having wrist hand issues after ending prednisone.
I have/had exactly the same issue. Let me tell you what I did to help avoid pitfalls. Year ago (May2018) I developed pain and swelling in my right palm. The most painful part was base finger joints. I was at 3mg dose at the time. After seeing rheumi, he upped my dose to +5mg ( to 8mg) . pain went away immediately and swelling after a month or so. That is the good part. It took me almost a year to get back to the same dose ): .
I was very slow in tapering bellow 3mg ( since last time I had issue at that level. This year, in July I was at 1.5mg when the same problem came back - swollen hand. Rheumi confirmed it was sinovitis with ultrasound and this time I went up to 5mg ( this is 3 weeks ago). Pain went away but swelling didn't. After a week I reduced to 4 and I just reduced to 3mg. I decided to try different approach. I am icing the area several times during the day and during the night I put a tape soaked with NSAID. The plan is to replace the anti-inflammatory effect of pred with localized treatment with NSAID. It is my experience that icing helps swelling the most. I also take hot bath every night and during that time I massage and stretch hand, fingers and wrist.
So that's my experience/plan and I hope it helps you.
Yes, localized treatment is the way to go if there's no other pain. What I find from the comments is that it happens at a very low dose, 4 mg Pred and lower, and that it is a recurring issue. The recurring aspect is scary! Yes, I've been icing several time during the day, raising my hand above my heart and sleeping with my hand above my head on a pillow. All this reduced the pain but not the inflammation. Thank you for your input! It makes me realize that I'm on the right track.
Not what you're looking for?
You may also like...
What do you think?
Hand issues - PMR related or not?
Sudden bruised swollen hand
Getting Sick and tired of PMR and other Stuff!
Pain in right hand
Related Posts
How many MG starting Prednisone do you think I should have been started on? 
Do as Rhuemy and Dr say re reducing pred ?
A flare-up has occurred at 9mg Pred, how much Pred to increase and for what duration OR remain at current 9mg. will my body adjust? 
Hand and arm tremors
new pain and hurting right hip, groin
Moderation team
