I was interested to read Kulinas post the other day, re the painful knuckles & fingers.,and subsequent replies.
I first came onto this site Sept 2018, having been diagnosed back in August of the same year.My Avatar of Stiff fingers spoke of on going issues.
Like most folk , I started on 30 mg and was reduced down to 15 mg and was told to taper blah blah….accordingly.
Went through the Moon Face phase , weight gains etc . Was comfortable on 5 mg.
Along came the Pandemic , went through Covid twice, my Rhumy appointments were by phone , and I was given a new taper regime ….. All going well .
Christmas just gone I started to suffer mad pains in my right thumb& wrists( I couldn’t use a pair of scissors, hold a pen ) Hoped it would disperse eventually…it didn’t , and the pain was worsening. Couldn’t hold on for my NHS. Appointment.Eventually I went Private to see a consultant. He felt it was De Quervains tenosynovitis , and I consequently had an injection into the joints.
Just prior to my Hospital Appt, my Rhumy rang unexpectedly to see how I was fairing and to enquire where I was with my Pred dosage?.I advised I was on 2 daily and doing good, but related to him the wrist issue , and advised I had upped this to 5 daily to relieve, as I believed it was PMR related. Shock horror he told me not to increase” we need to get you off the Pred”!
I am now on 1 mg , due to go to 1 every other day next Thursday. However since the reduction my left hand now is developing knuckle& thumb issue aswell . I’m finding it extremely difficult to make a fist , and in doing so 1 of the fingers is springing back ( Trigger finger) ?
Anyway I’m in discomfort. In your opinion, is this PMR related?
Do I go against Rhumy advise and go back up , or will that not be the case as I believe it’s OS anyway!
BTW the wrist pain is still apparent, however much less so & my thumb is mobile.
Thankyou & regards
Paul ( slightly stiff fingers)
Currently in the Caribbean. Thought a hot climate would have helped. In all honesty it’s got worse 🥵🤷♂️
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Stifffingers
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I find humidity is the worst thing for stiff hands - or anything else! Add wind and it's worse.
Whatever it is it sounds inflammatory - and any rheumy who considers 2mg pred is worse than symptoms needs a reality check if you ask me. If your other guy diagnosed tenosynovitis it is very possibly PMR-related - and could be plus OA too. Did the 5mg pred make a significant difference?
Wow. Really ? Sun & wind ? OMG who would have thought🤷♂️. 6 mg ? No not really.The other consultant I saw , is also a Rhumatologist. He asked me to raise my arms above my head. , which I did.
Humid - not sun, dry sun often helps. Don't advise anything - but if you feel worse in the Caribbean, makes sense to go home I suppose. Usually cheaper and more comfortable living there ... But the right dose of pred would be the best and cheapest option!
Find someone who knows what they are talking about - being able to lift your arms above your head has nothing to do with ruling PMR in or out. Often PMR does affect the shoulder girdle but that is not always the case, it affects either shoulder or hip girdles or both. No fixed rules. Once the shoulder bursitis is managed with the right dose of pred, it often doesn't return. Mine didn't. And tenosynovitis is part of the range of symptoms in PMR.
I was being flippant , re returning home. Of course that would never have been an option. As it so happens we return to the UK Sunday. I,m still at a loss to your comment that this wonderful climate puts me at a disadvantage to wet , and damp uk. Anyway…… Can I clarify , that you believe , the Tensovitus , the stiff sore knuckle , the finger that doesn’t want to bend are all PMR related.?
Do I increase back up again. ? Have to add , I swim daily , my walking is good , I can cycle. I am permanently Stiff, but then again I was never ever really supple…
One thing I would like to mention. Maybe this resonates with someone. Since the onset of the PMR , my toes are permanently numb. The Rhumy says no way is this part of PMR symptoms , and my Dr,s do not know why either?
Thank you all for your comments. I look forward to reading your responses .
Didn't say it did - I said that humid and heat isn't necessarily any better than humid, cool and wind.
The tenosynovitis MAY be PMR related - not really any way of knowing. And you aren't the only person to have numb toes - same there, it MIGHT be associated with their PMR. I wonder if it is a foot equivalent of carpal tunnel or ulnar nerve entrapment?
I don’t believe either Rhumy said that. The Professor I’m under , happened to remark , he wants me off Pred. The second one who diagnosed the Tensovitus, felt it wasn’t related, and also felt due to his arm raise test, that I was in fact clear of PMR.
If they want you off pred at the expense of symptoms it is tantamount to saying it is wrong for you to be on pred. On another thread a rheumy wants a patient to take 3 different drugs that we know don't work in PMR rather than a single 5mg dose of pred. If the diagnosis is PMR then pred is the right medication. The symptoms you describe are commonly found in PMR patients and respond to a low dose of pred.
I have trouble with my hands since PMR. I had trigger thumb last year, very strange. I could not move my thumb smoothly it would just click into place. In the end I could not move it at all. It was also very painful at the bottom. In the end it went away, although the bottom of my thumb is still painful.
When I had trigger finger some years ago a physiotherapist helped me find the place which was catching and how to massage the area. It went away very quickly and has never come back, no residual symptoms.
Probably a better option than what my doctor offered me which was they could snip the "catching" tendon. It was this possibility which sent me hightailing it to the physiotherapist!
I think that was my problem finger too. So long ago now I don't really remember, but I think it must have been. The cure, via massage, was so simple I can't understand why my doctor didn't suggest it. He was usually very good at finding the simplest, least invasive solutions to things.
The physiotherapist I saw, who was quite young so this was new for her, actually sent me home the first day and did some research. When I went back she showed me how to find the place where the tendon (or whatever it was) was catching, and after that it was a simple matter of massaging the area to kind of smooth it out. I can't describe it any better than that. Once the two of us found the right place it was quite obvious where it was, and I guess that can be found by knowing the anatomy of the hand and how the "sticky" digit is attached. I think if it were to happen again I would spend a little while gently exploring the ridges you can feel inside your hand where the bones go from finger to wrist, particularly the affected finger, until feeling something not quite right, a bit like twanging a rubber band which is slightly out of position.
Makes total sense. I have to say actually pressing the bone / joint at the base of the finger is really a tough call , as it’s very , very, painful to do so. However I will endeavour to try.
I didn't press any bones. My physiotherapist knew where to look for the problem bit, and it was pretty much in the centre of my palm, and then she demonstrated how to move the tissue over the place, and I could feel it was different, and I would do this from time to time over the next few days, then I was better. When it recurred, which it did once or twice not long after the initial problem, I just did the same thing. So gently feel your way down from the joint which joins your affected digit to the palm, following the bone which is hidden in your hand, moving gently back and forth. IF you find a spot where you feel something different (the rubber band shifting is the best I can do to describe) then that is where you concentrate your efforts. But you are always, always, gentle. All you are doing is encouraging the out of place thingy (I don't know if it's a tendon or something else) to move in its normal way. If you can't find the place, then if you can have just one appointment with a physiotherapist that could help. I think it is worth trying. Just to clarify, I didn't attempt to manipulate the sticky place. All I did was gently move the area around, like you might gently loosen a knot before attempting to untie it, and then let nature take its course (the actual untying).
I just looked up hand massage to help trigger finger, and there is heaps of stuff available now, including videos! Have a look and see if there is something which will help your particular issue! Good luck!
I had trigger thumb over a year ago. I had a cortisone injection. Took 2 weeks to work but been perfect ever since. Then had trigger finger, which also fine now with injection. Every time they triggered, it made me jump out of my skinMost unpleasant.
It was very odd the way my thumb would just click up and click to a bent position. It did just not work at all eventually though which made it difficult carrying things. I did not have a steroid injection.
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