Can PMR/GCA cause carpal tunnel syndrome?
I started to taper on Sunday and dropped from 13 to 12. I’m having pain in my right wrist and more “locking fingers”. It’s harder to write and draw.
I’ve never had carpal tunnel problems before.
I felt a bit of wrist pain before I started to taper.
I did find a reference saying carpal tunnel syndrome is a rare symptom of PMR...and also another reference to it being associated to autoimmune diseases like rheumatoid arthritis (PMR not specifically named, but then often it isn’t!).
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Carpal tunnel is due to the nerve being squeezed in the carpal tunnel area - and if it is due to inflammation higher doses of pred will have also relieved that. Pred also relieves oedema due to an inflamamtory cause. It is said that about 15% of PMR patients also have symptoms of carpal tunnel and it is suspected that more would be found if they looked for it.
I wonder what % of people without PMR have carpal tunnel? It is very common I believe (I had it years ago and the operation on my right wrist also cured my left!)
"Carpal tunnel syndrome is the most common entrapment neuropathy, with a prevalence in the general adult population ranging from 2.7 to 5.8 percent."
Yes, Possibly! I started PMR in December 2019 & was diagnosed with carpal tunnel September 2020...when I asked, I was told there is some linkage between the two. But all my hobbies use my hands to excess during this covid period & the carpal tunnel could have been there, waiting to pounce! When it became evident there was something wrong, I was on around 7mg Pred. At the doctor’s suggestion, I bought splints & sleep in then at night, which is helping. However, my OA became inflammatory arthritis just a month later & hands & feet are the worst parts, so more likely linked to that! Sorry, but it’s not always straightforward!!
Part 2...however, my fingers don’t lock up, I get tingling & numbness & pain in thumb & two fingers & weakness in wrist. When I googled ‘fingers locking up’ I got ‘trigger finger’ & that is not mentioned in the symptoms of carpal tunnel that I just looked up. Sorry, but I’m not a doctor...you may like to look both up & see if your symptoms fit either, or both! Good luck.
Thanks for the information Pixix. I’ve had the locking fingers thing since I injured my hand a few years ago (cuts across the tips of my fingers but not really too bad. I had hand therapy with a physical therapist then. Since pred the locking has gotten worse, it’s starting to interfere with drawing and writing. My dad had Dupuytens contracture and had surgery for it.
One more body part acting up!
My PMR started with what I thought was carpal tunnel....turns out it was PMR. I got an ergonomic keyboard and mouse and went on Pred and it went.
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Interesting article (sorry I don't have link) on this subject.'Carpal Tunnel Syndrome with Polymyalgia Rheumatica' by Tahir Ahmed and Alan Braun.
All my problems started in the left wrist and having treated patients with Carpal Tunnel Syndrome myself, I was fairly sure that this is what I had. Slowly developed severe shoulder and neck pain and have a possible diagnosis of PM and am on Pred. That is a year ago and I have had no recurrence of shoulder and neck pain but still get slight pain in wrist.
onlinelibrary.wiley.com/doi...
the Abstract just says "Association of carpal tunnel syndrome with systemic diseases is well established. Carpal tunnel syndrome preceded or existed simultaneously in 5 patients with polymyalgia rheumatica. It is probably related to tenosynovitis resulting in increase in the volume of the contents of the tunnel."
Full text as PDF here:
onlinelibrary.wiley.com/doi...
Perfect, thank you.
I nearly missed the PDF offer!!!
I developed what was thought to be Carpel Tunnel syndrome whilst on the lower doses of Pred. when I had PMR in 2019. It had the symptoms as specified but the physiotherapist thought it originated with a nerve in my neck. I've never had this checked though as Covid19 came and all the outpatients appointments were cancelled. I've been living with the pins and needles in my first three right hand fingers and thumb since then and have got used to the sensation. Still waiting for a nerve conduction test!
Sounds uncomfortable, I don’t have tingling. Mine seems more like a problem with the tendons.
I’d be curious to find out what you learn. I’m down to 3mg a day of pred after a flare last September. The first three fingers of my right (dominant) hand develop pins and needles whenever I work on my computer. Of course my osteoarthritis in my hands is also worse. And neck and shoulder pain (which usually is my first clue of PMR issues) has returned. Every day is an adventure ...
That’s exactly the same as me, had MRI scan and have got some protruding discs and possible compressed nerve, 2nd MRI revealed it is not compressed nerve from my neck and is most likely carpel tunnel. My wrists are also quite weak on some days but all this started when I was on 9mg. I’m now on 2mg pain is not as bad as it was. I do get pain and weakness in my wrists on odd days but manageable.
I've had this a few times,fingers locking, really bad cramping sensations and wondered if it was due to GCA. I swapped the adcal to a lowest dose calcium and magnesium tablet and it seems to have stopped.I found it so scary, the finger and thumb locking. It was so painful.
Glad it stopped, one less thing to worry about!
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