Hand stiffness: I feel I am having a relapse of PMR... - PMRGCAuk

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Hand stiffness

maureenburton profile image
33 Replies

I feel I am having a relapse of PMR - just spoke to my GP who said PMR doesn't usually affect the hands. My most painful areas are my hands and my arms. Has anyone else had same area?

Also has anyone been put on steroids for a short time as this is another suggestion?

Thank you

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maureenburton profile image
maureenburton
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33 Replies
PMRpro profile image
PMRproAmbassador

Sorry GP person - wrong! If PMR presents with RS3PE syndrome, it affects hands and feet. Many of us had problems with hands and feet and Leeds did a study a few years ago and found that yes, PMR can also affect hands and feet - unfortunately, Covid got in the way and they haven't yet published it. I have complained about that!

If it is PMR then a short course of pred will work as long as you take it - stop taking it and the inflammation will build up again. You say relapse - how long have you been off pred? Have you any other problems? I have hand and arm pain at present but I'm pretty sure it isn't PMR, the hands coul well be OA, the arm muscle pain could be simply long term pred use after 13 years.

maureenburton profile image
maureenburton in reply toPMRpro

thank you

Janstr profile image
Janstr in reply toPMRpro

What part of the hand does PMR affect?

PMRpro profile image
PMRproAmbassador in reply toJanstr

In my case, it all hurts. At the start it was wrists and individual finger tendons when I made certain movements. That still happens now and again but rarely. The bases of my thumbs ache too - they and my wrists are usually the first painful area in a flare. This soreness now seems different though.

maureenburton profile image
maureenburton in reply toPMRpro

Its hard to tell isn't it. My knee (not new one) is very painful and stiff this morning. Had my bloods refine yesterday and ESR almost doubled. CRP gone down a bit though. Hands and arms still most problematic.

PMRpro profile image
PMRproAmbassador in reply tomaureenburton

Is there any other reason for raised ESR? A cold or something? Had they returned to normal after the TKR? No signs of infection in the knee?

The other knee COULD be sore because of the changes in how you walk with the new knee. Are you still using crutches after this amount of time? Has your use of painkillers changed?

maureenburton profile image
maureenburton in reply toPMRpro

I did walk quite a lot the day before. The most I'd walked since op , I was wondering if that. Strange that CRP went down too. My other knee hasn't felt like this before tho but appreciate its probably been over worked. I haven't been using crutches for a week or so. Physio said don't use as maybe them causing pain in arm/hands.

Tried codeine based painkillers to see if got rid of pain but it didn't.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply tomaureenburton

So are you using walking stick/sticks?

maureenburton profile image
maureenburton in reply toDorsetLady

At home no crutch or stick as physio said that may be problem. Outside stick just for bit of confidence and also just to keep people away from me and give you time crossing the road etc.

I know inflammation markers will be raised due to op. Op was 5/9. Did do lot of steps day before it was nearly doubled so really hard to tell. Stiffness is in arms hands and knee today. Not hips. Stiffness in legs but to be expected. Just don't want to end up on steroids again for a number of years if it's osteoarthritis. Not sure whether to see a rheumatologist?

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply tomaureenburton

Think you probably do need to get medical advice if painkillers aren’t helping - if it is a PMR flare then the sooner you catch it, the better.

PMRpro profile image
PMRproAmbassador in reply tomaureenburton

I agree with DL - I think you need medical advice.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply tomaureenburton

As PMRpro asks any reason for increase in ESR -how long ago did you have knee done? If found my ESR (GCA long in remission) was high after replacement surgery….and not just after, a few months after.

Ditto to other questions….

PMRpro profile image
PMRproAmbassador in reply toDorsetLady

Don't suppose you would have noticed - did more exercise using the affected muscles make the markers go up?

maureenburton profile image
maureenburton in reply toPMRpro

I'm not sure as have only had two blood tests, two weeks apart. Have been exercising each day after op but day before last test was the most I'd walked since op.

PMRpro profile image
PMRproAmbassador in reply tomaureenburton

i wouldn't be surprised if that had some role to play.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply toPMRpro

No, because it wasn’t tested until long after rehab was completed.

I asked for ESR to be tested as part of annual health check just out of interest -GCA in remission at least 18 months by then. If I hadn’t had it tested, I probably would never had known didn’t have any obvious symptoms -just being nosy…

Did write about it at time -

healthunlocked.com/pmrgcauk...

PMRpro profile image
PMRproAmbassador in reply toDorsetLady

Yes, remember that

Janstr profile image
Janstr in reply toPMRpro

I’m getting a sharp pain momentary pain on the top of my hand at the base of my thumb on the first finger side. I hadn’t thought it might be PMR. I have just reduced to 4.5 & it’s only been occurring over the last couple of weeks in the latter stages of the reduction using DSNS . The pain only happens when putting on a brace for a broken ankle & torn tendon. I have only had the brace for a couple of weeks, so it may be an angle I’m not used to.

piglette profile image
piglette

Are you having the normal PMR pains too such as bilateral shoulder pain and hip pain? Had your GP given you some steroids yet? At least you can do a test and see if they help. Have you found painkillers generally help the pain??

maureenburton profile image
maureenburton in reply topiglette

It feels like PMR to me but mostly my arms and hands hurt. Legs sore too but just had a knee replacement so I feel it's that in my legs. Arms feel heavy.

GP was going to put me in steroids straight away but I wanted another blood test just to see if the CRP and ESR are elevated from last test.

Painkillers don't seem to have helped.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply tomaureenburton

Blood tests very often lag behind symptoms - so may not show anything as yet...the fact that paracetamol don't helps steers towards PMR, despite what GP thinks!

piglette profile image
piglette in reply tomaureenburton

I think I would give the steroids a go for a few days. Blood tests can be a bit iffy.

Missus835 profile image
Missus835

Yes. Last year my right hand was pretty much unusable. Had to wear a split to support it and eventually could not work, because I could not hold the mouse. This went away immediately in January when I started Prednisone. The middle finger right hand still stiffens up by times and I work it with a soft rubber ball (just squeezing). I'm back to full capacity with the mouse and back to work almost full time. Still on 12.5 mg Pred. but weaning down very gradually. It also affected the back of my arms, shoulders, neck. I was unable to dress because i could not put my arms back to do so. Could not wipe and then it started up the backs of my legs and into my buttocks. Excruciating. So in answer to your intial questions. Yes!

maureenburton profile image
maureenburton in reply toMissus835

Gosh poor you . Thanks for the info. Carry on doing what your doing. Good luck.

Janbay46 profile image
Janbay46

I didn't suffer much from hands when I originally got PMR, but they were the main symptom in my first (so far, only) flare. They swelled up, and I couldn't clench my fingers into a fist- in fact, I could hardly move my fingrs at all. There wasn't a lot of pain, but they looked and felt like baseball mitts. The same with my feet, they went up two shoe sizes. No problems in neck and shoulders.

20 mg Prednisone brought my hands and feet back to normal, but it took a week or two. I am now down to 5 mg, and have pins and needles in my right hand and arm, quite severely, for most of the day. It has been about two weeks since it began. Went to the doctor and had blood tests, the results were pretty nornal so no diagnosis. I think in between flares, perhaps this disease has weird symptoms which come and go.

maureenburton profile image
maureenburton in reply toJanbay46

Thank you.

That's exactly what i have with my hands. I didn't realise you could get a short term dose like you have had - did they tell you how long you would have to be on steroids? My GP said I'd have to be on for as long as it takes. This is my first flare but have had surgery so think that's what has sparked it.

.

Janbay46 profile image
Janbay46

My GP and rheumy didn't predict how long I'd be on steroids. They are quite relaxed about my present dose of 5 mg, but advise me to start Methotrexate if I have another flare and need a higher dose of Pred again. I'm due for a cataract op next month, so am not trying to reduce the Pred until the op is over. When I do, it will be very slow- down by 0.5 mg/month, or maybe 0.5/ six weeks, depending how it goes.

maureenburton profile image
maureenburton in reply toJanbay46

So your flare was/is whilst you were on steroids?

Maryis80 profile image
Maryis80

my hands have been affected on and off for the five years I have had PMR. Sometimes swollen or really stiff and difficultto hold things. Also a couple.of instances of trigger finger/thumb one of which my rheumatologist treated with cortisone injection which seemed to cure

Janbay46 profile image
Janbay46

Yes, I had begun on 20 mg Pred and was down to 8 when I had the flare. I had a covid booster a few days earlier, and thought it might be the cause. With the flare I went back to 20 mg, and began the long slow taper.

In fact, I stayed on 20 mg too long, for two months, , I hadn't been reading the posts on this newsgroup very carefully and had the impression that high levels of steroids were OK. My GP noticed and phoned me up, now I have to have a phone consultation with her every month before I get prescribed Pred. I think she is a very good GP!

PMRpro profile image
PMRproAmbassador in reply toJanbay46

Often when you have a flare, adding 5mg to the dose you are at is enough. I think a lot of us had short mild flares after a Covid jab, I did after the second Moderna which lasted a few weeks - nothing with any of the others.

maureenburton profile image
maureenburton in reply toPMRpro

I'm not on steroids tho - been off them since 2020. Difficult thought going back on them.

PMRpro profile image
PMRproAmbassador in reply tomaureenburton

Given the difference between how I felt on pred and how i was off it - there was no context! They gave me my life back.

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