Worrying about stiff fingers

[Pangolin43]

Good morning everyone,

I’ve been taking 12.5 mg of Pred for 3 weeks now having had 15mg for the first month (since diagnosis). I have also returned to work which I am struggling with.

I feel as if my symptoms are beginning to show again. My wrists are particularly sore and my fingers very stiff first thing in the morning. My shoulders also feel achy. This takes a few hours to dissipate. I take Pred at 4am.

My rheumatologist wants me to reduce to 10mg once this month is over. I’m wondering if this is a good idea. I also have my second COVID-19 van tomorrow. I wonder if this is a flare due to work stress. The stiffness in my fingers particularly worries me. Is it a PMR symptom.?

Can anyone help me with this?

Thank you

[DorsetLady PMRGCAuk volunteer]

See my reply to this post re tapering..healthunlocked.com/pmrgcauk...

And yes most probably a flare due to combination of return to work and too fast a taper. Many say fingers are affected by their PMR

[Pangolin43 in reply to DorsetLady]

Thank you Dorset Lady. I thought as much. It seems to make sense.

[PMRpro Ambassador]

Stiffness in fingers can be a PMR symptom - it is for me.

I agree with DL - too fast a reduction especially with you having gone back to work. And I wouldn't think a reduction to 10mg is a good idea if you have symptoms returning. Whether you can persuade your doctors of the sense of that I don't know. But you need to try. Some people can reduce the starting dose at that rate, most can't - especially since the 15mg starting dose is towards the low end of the range of 12.5-25mg recommended in the 2015 recommendations.

ard.bmj.com/content/74/10/1799

[Pangolin43 in reply to PMRpro]

Thank you PMRpro. Both yourself and DL always make sense.

[DorsetLady PMRGCAuk volunteer in reply to Pangolin43]

That’s a rash thing to say😂😂🤣....but thanks!

[PMRpro Ambassador in reply to Pangolin43]

We try. We are very trying ...

[Hidden in reply to PMRpro]

I’m known to say that the inscription on my tombstone will be “ here lies a trying woman “. Interpretation open.

[SheffieldJane]

Does your work involve computers? Your symptoms are of the type that can be triggered by lots of screen and keyboard activity. There maybe wrist supports, ergonomic chair, speech technology aids and adaptations available to help. A right under the equalities act.I would not begin a taper if I was so symptomatic, it is just asking for a flare.

I have stiff fingers and my Physiotherapist has given me a series of exercises that stretch them at each joint. It seems to help. I think mine is osteoarthritis, there is a little swelling. My husband has this and since my son taught him to play the guitar he has been a lot better.

[Pangolin43 in reply to SheffieldJane]

Hello Sheffield Jane thank you for responding -I’m a teacher and do use the computer often. I’ve got some wrist supports which I use and they do help. My hands and wrists seem to suffer more than any other part of me even when I’m not at work and this has been the case since diagnosis. Although the symptoms ease throughout the day I still can’t wear any of my rings. I also do exercises for my hands.

After reading the responses I am not going to reduce Pred yet. I think a reduction in work or even retirement would be the best option.

😀

[SheffieldJane in reply to Pangolin43]

I think you’re right you know. I had to give up. Too much dancing to another’s tune.

[Telian in reply to Pangolin43]

Have you tried wrist supports? Mine were ‘made to measure’ because of wrist surgery and they are a comfort. Ask the pharmacist if they can be bought otc. If not and it’s an ongoing problem then talk to your GP. You won’t necessarily need them all the time but they are a good standby.

[PMRpro Ambassador in reply to Pangolin43]

"I think a reduction in work or even retirement would be the best option."

Can tell you now - retirement can be a Very Good Thing

[Bcol]

Good morning, I have wrist and hand/finger problems, which I suspect may well be Carpal Tunnel Syndrome. It has certainly become worse as I have tapered my Pred downwards. Whether it is the PMR reminding me of its presence or just the Pred having masked the previous problem I'm not sure. My right hand/wrist is more affected than my left, although I think it is caching up. I wear a wrist support at night which helps to some extent. I will have to talk to Doc if/when it gets worse as it is becoming a bit of a pain!!!! When at the age of 52 I finally got my head around the thoughts and neccessity of medical retirement from teaching it made a huge improvement in my life.

[Pangolin43]

Hello Bcol,

Thank you for your response. 52 is young and the thought of continuing for another eight years in what has become an extremely stressful job with this condition is a scary thought. I think you did the right thing taking early retirement. I hope you have felt the benefit.

I’m 59 due to retire at 60 in December. I’m lucky I’m in the teachers pension scheme. I don’t think I can hold on until December and have made the decision to resign at the end of this term 3 months early and focus on my health. I will be time rich and financially poor but I can survive and thrive off very little and I’m looking forward to it. 😀

[PMRpro Ambassador in reply to Pangolin43]

Will that few months significantly impact on your pension? It is probably worth getting the union on-side for early retirement on health grounds and at least get signed off sick for as long as possible.

If it is any consolation - we took a massive income cut when OH retired early although he had done the sums to be sure we could live well, but we spend so little in retirement it has never been a problem. Clothes last much longer, you don't spend as much on food because you have time to cook and you aren't tied to the peak periods for holidays - we have stayed at home in July and August ever since!

[Pangolin43 in reply to PMRpro]

It won’t impact significantly and I don’t want to retire due to ill health unless it’s absolutely necessary. This is because I may want to do the odd day on supply in the future and you can’t if you have retired due to ill health. My plan is to wait and take my pension in December so that it doesn’t reduce.. I’m lucky that this is possible for me. It’s not long to wait and as you say PMRpro there are lots of pluses. 😀

[PMRpro Ambassador in reply to Pangolin43]

Ah so! Seems a bit crackers since you can be too unwell to work at the time but recover and be of great use later.