I was diagnosed with PMR nine years ago and have had my ups and downs but I was fairly settled on 5mgs of Prednisolone. I now have another flare with the usual tiredness and painful shoulders and hips. However, for the first time I also have pain in my shins and ankles, my forearms and hands, but especially in my wrists and both thumbs. I’m presuming these are still symptoms of PMR. I did increase my dose to 7mg with little effect but having read the reply to an earlier post I will add 5mg to my previous 5mg and increase to 10 for a while. I just wondered if others had experienced similar pain in their wrists and thumbs.
Pain in wrists and thumbs.: I was diagnosed with... - PMRGCAuk
Pain in wrists and thumbs.
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61EllieCheshire
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I do, always have had pain at the base of my thumbs and in the wrist. I don't think it is OA,
I had pain in both my thumbs at the basil joint which is the joint of the thumb that meets the palm. And mine was osteoarthritis and was terribly painful and made it difficult if not impossible to use my thumbs. I had my right thumb repaired 2 years ago and my left thumb repaired this past winter. It is quite a unique surgery in that they use a piece of the tendon of your forearm to replace the joint in your thumb. And it works really well. I do not regret either surgery.
Yes, I have. It came on about two years into pmr, and was resolved almost instantly by a short term increase in pred.
Paddy
I started with intense pain in my right thumb area, it then went to my left thumb area and I even got trigger thumb. I still have some pain but things seem to have improved, so I am not sure what the problem was or is. The GP’s diagnosis on my notes is ‘pain in thumb’!
Is his name Tom?
It is a she in fact but possibly related. I had a ‘discussion’ with her for recommending Naproxen.
You are a pain somewhere for her 
hi, yes, pain in thumb, up to and including wrist. I’ve been wearing a wrist/ hand brace at nite to hold my iPad device. I think I have repetitive motion syndrome, for which my rheumy gave me cortisone shot. Only helped for 2-3 weeks, and pain is back. The scary thing is that she is talking RA, and methyltrexate or some other new RA drug. After 10 years with PMR, I still use 6 mg pred…but I’m not ready to move over to the other drugs.
So far no other indications of r.a..
So, back to wrist pain,…you might try paying attention to how you hold your electronic devices…alter your hand positions with pillows, etc, see if that helps.
Kind regards.
Things have improved in my right hand, it seems it us time that did it! Also the trigger thumb just went away after nine months.
Can go with painful thumbs, but managed "trigger Thumb" yet. Do have trigger finger on left hand hand, middle finger, which is a bit of a pain at times.
Really annoying having trigger fingers or thumbs. Quite interesting the way it clicks into position.
Certainly annoying and a very strange feeling when it straitens up, think it's all tied into my CTS which is still ticking along.
I had CTS symptoms before I was diagnosed with PMR. Things seemed to get better when I started in steroids.
Likewise, I had minor symptoms, but to be fair I suspect I had had PMR for a good few months before diagnosis, I just put it down to worsening OA aches and pains. Previous experience shows that my CTS will disappear if I go back up to 10mg and then taper down slowly again, which I have permission /agreement from the doc to do, he has left the decision up to me. At the moment it's not dire and I'm reluctant to go back to 10mg unless I need to. On 2mg at the moment.
And piglette I had trigger finger. Doctor suggested snipping the tendon. I inwardly shrieked EEEK and went to a physiotherapist. Who, after doing a little research, showed me how to find the tendon which had slipped out of place and how to massage the right area. It went away and never came back. Mind you, I was a lot younger then; maybe the cure wouldn't be so rapid and complete now.
Still, piglette, better than 'hairy legs' which I saw was noted on a Dr's notes about me once (I read it upside down, but it was definitely there). I won't go into further details on this occasion!🤣
I think I would have been a bit miffed if I saw that on my notes!!
I was younger at the time and it didn't seem to worry me that much. Also I think he noted it because of the drugs I was on, which I'm still on! Thinking about it though, it was rather an odd and unnecessary comment.
when I first went to see a GP with PMR my notes say ‘feels unwell’!
How funny (or not)! Covers a multitude of sins and I imagine that could be written on every patient's records! Did it take long to diagnose PMR for you?
He never diagnosed it, I went back over at least three months, he said it was a virus! He then said it was nothing to worry about. I even asked him could it be PMR. I am not sure he knew what PMR was. In the end I saw a rheumatologist privately who diagnosed PMR in around 30 seconds. I was in a really bad way by then.
Goodness me. Shocking! and I'm not at all sure things are improving much, from what I read on here. It was some weeks, for me, before diagnosis, by which time I was crawling upstairs. And it wasn't my surgery that twigged it but a telephone conversation with a (private) physio, who hadn't even seen me. Ever grateful to her, particularly since she wouldn't charge me! It sure is a battle, just when one is feeling at one's lowest too.
I so agree.
See my comment further down re this. It slotted in, in the wrong place!
I have, though turns out it is OA of the STT joint in my wrist. A steroid injection into the wrist joint and base of thumb has worked like magic though. However, painful feet and ankles have always been a feature of PMR for me and there is no OA in my feet.
I hope upping the dose a little gets you back on track and resolves your symptoms.
I have extremely painful shoulders, arms and wrists and altered feeling in my hands- but mainly on the little finger side -- every time I try try dropping from 2.5 mgs. of Prednisolone to 2 mgs. I have been told that it was ulna nerve impingement from the steroid drop. Don't know if this is of any help.
After about 3 years on prednisolone I have been on 5mg for some months. If I grasp anything heavy with either hand, strong burning pains shoot from my wrist up the ball of my thumb. This has been happening for quite a while.
Like you I've been experiencing pain in both of my hands. I feel it particularly around the thumb and forefinger and it extends back up to both wrists. It started a couple of days after I reduced my pred from 3mg to 2.5mg.
I'd just seen a rheumie for the first time in 13 years!! in May of this year and she told me I can't have PMR after 13 years, but that it must be OA. So I asked her if she'd told my PMR that it didn't exist. She was not amused, but then neither was I, and I wasn't about to be bullied by her. Anyway, she ordered X rays on my spine, from neck to coccyx and told me that there was 'wear and tear' on my spine at both ends. I already knew this.
It's hardly surprising, as I worked as a motorcycle courier for 10 years in London through the 80's and it didn't do my skeleton any good at all. Wearing a 4lb fibreglass crash helmet all day long, and bouncing around on a motorcycle saddle don't do much for skeletal health, or prostate health either (but that's a different story!), and now I'm suffering the consequences of those 10 years working on a bike.
Anyway, she told me to try reducing my pred. I told her I was keen to do so anyway, as I want to get off pred if I can, because I have tinnitus that started the day after I started on pred, and my hope is that if I come off pred, the tinnitus will fade away.
So the following day I dropped from 3mg to 2.5mg and have been on that now for 3 weeks. However, something I didn't tell her (because I'd forgotten about it) was that a couple of years ago I got down to 2mg, and stayed at that level for more than 3 months. But I had to increase the level back up to 4mgs when I found that my hips and upper thigh muscles were so painful at night that I couldn't sleep unless I went downstairs and slept in my armchair with my feet up on a pouffe.
This time around, the pain is shared between both of my hands, and my thighs and hips. So I think I'll carry on at this level for a month or so to see if it subsides. If it does I'll stay at this level for a while, but if it gets worse then it's back up to 3mgs as I was fairly stable at that level.
As many have discovered at such low doses even 1/2mg does make a big difference.
If your pains returned only a couple of days after your drop from 3mg to 2.5mg it could be steroid withdrawal -but they should disappear after a week or so. If you still have them longer than a week or two then that might indicate that 2.5mg is not quite enough…so don’t let it go on too long before you do something about it.
You might also find that a slower tapering regime (see below for examples) and (if you can) a drop of only 1/4mg a time might be beneficial…
healthunlocked.com/pmrgcauk...
I use my pill cutter to cut the very small 1mg tablets into halves. Trying to cut each one into quarters may prove a little more difficult for my clumsy fingers, but we'll see.
Yes I do realise it may be difficult -but it may not be necessary.
My ultra slow taper was designed to help people who find it very difficult to reduce -each week is repeated so it takes 14 weeks to get from current dose to new lower one.
Since you have been on pred for so long there is also adrenal function to consider - which she is forgetting it seems. And sorry, ma'am, but after 18 years MY rheumy is perfectly happy I still have PMR and using Actemra I have been able to get to 6mg pred - it wouldn't do anything for OA and MY pains are definitely different, OA doesn't affect muscles.
But she is being a tad silly about worrying about 3mg in people our age.
I totally agree. She's considerably younger than I am, and she isn't feeling the pains that I do. So whatever she says is fairly irrelevant, except that after the X rays she wanted me to see about going to a pain clinic. She's also ordered a synacthen test for the 20th, and a DEXA scan on the 24th, and then I have to wait till October 5th before I see her again.
Well, I didn't say anything regarding the pain clinic, but I don't think that painkillers will stop the PMR pain in my muscles, so I'll carry on taking the pred unless or until she either cuts me off from them altogether, or gives in and lets me control my tapering. I sincerely hope it will be the latter, because I don't want to end up in hospital due to her stubborn ideas about PMR.
One of the best things about a good pain clinic is that they have a different view of medication. My pain clinic doctor never makes a fuss about reducing pred - but looks for alternatives to deal with the things pred won't sort out! The first thing they did was a physical exam and established my entire back musculature was as solid as floor boards. Task: to un-spasm them and work out what had caused it in the first place. That is a combination of myofascial pain syndrome, a scoliosis and PMR superimposed. Sort one thing and another may develop - so there is never a single approach without thought of something else if required.
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