Hello
PMR diagnosed in Nov 2020 and now on 2.5mg prednisolone and felt I was doing really well, until the onset of hand pain. It started with slight discomfort and stiffness in the morning which wore off quite quickly. Now very painful at night and fingers are swollen. I don't know whether this is incidental, a withdrawal symptom or not enough pred. Has anyone else had this? Any advice greatly appreciated.
Hi and welcome!
To get down to 2.5mg from diagnosis in November is very fast and I suspect that while you need a low dose - 2.5mg is just a bit too low. One thing that can appear with PMR is something called RS3PE syndrome which can cause swollen hands and feet - it is treated with pred too and maybe it is still there and reappearing as you get to low doses. What dose were you at when you first noticed it?
HiThank you for your reply. I first noticed slight morning finger joint stiffness about 4 weeks ago when I was at 3.5mg. I wonder if this increase in pain and stiffness might partially be due to the very hot weather here in Cornwall. I will do some searches on RS3PE, thank you for that information. I suppose an increase in Pred dose is worth a try. Can you suggest a dose please and for how long? As you may gather I am a reluctant steroid taker!
If it were me I'd go back to 3.5mg and see how I got on. These are really low doses - Prof Dasgupta told us he often keeps patients at 2-3mg longterm as it reduces the risk of relapses. It's possible it is nothelped by the weather - especially if it is humid.
Yes, I started to get hand problems about a year after starting pred, diagnosed with OA and carpal tunnel. I think they said the carpal tunnel is seen fairly often either because of Pred or because of pmr, sorry can’t remember which! Also the higher doses of pred mask OA so as I lowered it became apparent. I had had mild OA in thumbs before pmr. You may wish to just check out the symptoms of those two and see if they fit?
Hello Marigold3 -And query for PMRpro - I also have experienced pain/needle sensation in my hands since reducing to 2.5mg (now 2mg) last few months - have reduced very very slowly. My hands tingle sometimes.
BUT is normal PMR pain always bi-lateral, ie felt on both sides of our bodies?
That's what most people say - but sometimes it can start on one side before the other or be worse on one side than the other, just like some people have shoulder pain and others don't. But if a new pain starts up on one side, it is probably worth considering it could be something else - at the very least something associated with but not necessarily directly PMR.
Your tingling hands - is it all over, all fingers, or just some of them?
Not usually thumbs and mainly lower ends of fingers - usually at night or when I get up. Stays until my ‘systems’ get going. I wouldn’t regard the tingling as bad.
Sounds like possibly a trapped nerve but could be peripheral neuropathy,
Morning Marigold. I'm suffering, particularly at night but also appearing more generally during the day, from the typical Carpal Tunnel Syndrome symptoms. Tingling, pins and needles, ache and pain in fingers and hand and difficulty in gripping. This has become more noticeable the lower I have gone with my Pred dose. Right hand worse than left at moment but left is catching up. Wrist splint certainly helps at night. I will mention it to doc when I next speak to her.
I had similar issue as you. It seems to be seasonal and it comes ( for me) in May for last 2 years. It responds to increased dose, but this year I opted for cream with 1% prednisone to locally treat the problem, rather then increase the dose. As far as dose increase, I had to go up +5mg to clear the problem BTW.
I have recently started tapering to 2mgs and the last two mornings have woken with very stiff right hand which is painful if I try to clench it. Yesterday the feeling of stiffness and inflammation wore off by midday. I'm monitoring it and was interested to see replies to your post as I hadn't connected it to my pred dose.
The entire hand? Just some fingers?
Particularly the middle finger - but already now at 9.45 it's beginning to feel more normal.
Mmm - but middle and ring, or middle and index?
Seems as if it's middle alone just now as the rest of fingers have returned to normal and middle just taking longer to regain full flexibility
I wondered if it might be a nerve problem - carpal tunnel which is median nerve or possibly ulnar nerve. They might be being pinched due to a bit of inflammation and previously the pred dose has been relieving it.
Yes I was wondering whether the steroids might be masking some inflammation in my hands, particularly as my sister actually has rheumatoid arthritis in her hands, and I've noticed my knuckles looking larger and a bit puffy.
Worth asking the rheumy - just in case as if it were it needs paying attention to sooner rather than later
Good idea. I'll do that.
Hand pain
Painful hands and carpal tunnel syndrome
Hand pain
