5mg prednisone is working now, body feels like it has adapted to the lower dose

[sdowney717]

Aches and pains are much subdued. I do think I can keep lowering, but I am a little worried about my hands now. As in maybe the small amount of prednisone is helping down the inflammation there. I have had carpel tunnel symptoms for at least 10 years. Now I know I have some OA in the hands from the xrays. I also seem to have had trigger finger but no fingers are triggering for the past month. Beginning to think maybe the tingling and numbness of the middle fingers could be related to carpel tunnel. Conceivably could have operation for carpel tunnel and trigger finger. Will see the hand doctor Sept 2, such a long time to wait. Other than hands feeling honestly pretty decent again.

I was making big drops, from 15 to 12.5 to 10 to 7.5 and now down to 5 over the last two months.

I do feel like I could drop more again. Does anyone think 5mg prednisone is helping my hands from getting worse? As in carpel tunnel? Is that an inflammatory thing? Trigger finger is tendons inflammation. I don't think 5 mg is a lot of prednisone. Sure it still has an effect on raising of blood sugar since I take insulin.

[PMRpro Ambassador]

Depends on how you look at it - 5mg is a low dose, on the other hand, in the context of PMR it isn't since even 1mg or less can keep a low activity of underlying disease under wraps. And that is the same at any dose - 5mg may be really good, 4,5mg not. I wouldn;t risk going to 2,5mg now - there is also adrenal function to consider now,

Carpal tunnel usually affects more fingers than just the middle one. But yes, it is inflammatory and the right dose of pred will keep it quiet.

[sdowney717 in reply to PMRpro]

I recall years ago having to shake my hands to get the tingling numb feeling to go away.

My ring finger is also slightly tingly, just a lot less than the middle fingers. Being a diabetic with neuropathy, I had been thinking it was maybe the cause of the hand tingling, but maybe it is a carpal tunnel situation. The strange sensations in the fingers has worsened the last few months even as I cut back on the prednisone. Middle finger has a slight surface numbness, but If I press into them, they do have feeling deeper down. This tends to make it harder to pick up small items.

I also notice getting on hands and knees, my wrists don't flex back enough. Wrist Xrays show no OA, RA, good bone spacing and they are normal on Xray. So my wrists must have a little soft tissue inflammation left in them. Don't know if Carpel Tunnel related or PMR, or Both.

Right hand no longer swells if i do not hang it off the bed.

Things like this tend to creep up on you, steady to slightly worse over long period of time and you kind of get used to it till you think about it.

[PMRpro Ambassador in reply to sdowney717]

Middle and ring finger MAY be affected by carpal tunnel and median nerve problems - mostly thumb to middle, occasionally ring - but ring and little finger are more likely an ulnar nerve problem

[Judywalks]

I was advised by Rheumy to stop Prednisilone in January and gradually reduce Methotrexate over a few months. I have experienced a lot of pain in my fingers and had a Carpal tunnel op six weeks ago. When I told Rheumy this she disagreed with me that it could be do to stopping Pred. I am seeing an Occupational Therapist at the hand clinic now. I have been on Prednisilone and Methotrexate for about nine yrs and still maintain that my hand problems started after stopping and reducing them.

I hope you get some help.

[PMRpro Ambassador in reply to Judywalks]

On what grounds does she say it isn't? Carpal tunnel is more common in PMR patients - and is due to inflammation, of course pred will help it. What dose were you on when she said to stop?

"What causes carpal tunnel syndrome?

The pain in your carpal tunnel is due to excess pressure in your wrist and on the median nerve. Inflammation can cause swelling. The most common cause of this inflammation is an underlying medical condition that causes swelling in the wrist, and sometimes obstructed blood flow. Some of the most frequent conditions linked with carpal tunnel syndrome are:

diabetes

thyroid dysfunction

fluid retention from pregnancy or menopause

high blood pressure

autoimmune disorders such as rheumatoid arthritis

fractures or trauma to the wrist"

[Judywalks in reply to PMRpro]

I have written previously about my difficulties with Rheumy and it hasn’t changed. She doesn’t listen to me or agree with anything I try to say. I was on 1mg every other day when I stopped. I had been tapering very slowly. I now see the Specialist nurse. Who is more understanding but she has to follow the consultant’s instructions.

The exercises are helping the problem with my fingers.

[PMRpro Ambassador in reply to Judywalks]

That would be plenty to make the difference! Sorry she isn't helpful - I wouldn't last long with her!

[Judywalks in reply to PMRpro]

I don’t have a lot of choice. I have spoken to GP who says they cannot help. I could complain to PALS but to be quite honest I just don’t feel like going through all that.

[PMRpro Ambassador in reply to Judywalks]

Fully understandable.

[HeronNS]

Reading Judywalks' reply reminded me that when I needed help for my hands, one time it was my wrist and thumb (work related) and another for trigger finger, both times a physiotherapist was able to prescribe helpful exercises. In both cases the problem has never recurred. Also both were before PMR diagnosis, but possibly after I had started having PMR symptoms.

My husband has complained of neuropathy in his feet for years. Finally the doctor told him to see a physiotherapist, who gave him exercises which he says are helping.

[Mayadill]

This is possibly going to sound very stupid and possibly obvious too but i thought I'd put it out there. After the Moderna jab i had a lot of problems with my hands, one thing after another, i'm a touch typist. The problems were greatly helped by typing and/or making 'playing the piano' movements. And worsened by that pernicious invention the smartphone! Do use all ten digits. Do not hold phone in one hand and hunt and peck/swipe with the other for any longer than a few minutes, not for instance for prolonged playing of a game. Or indeed writing a mail of any length.

[Pippah45]

This may sound a bit out there but I have read that the ring finger (if wearing a gold ring) is very often less prone to arthritis than other fingers. The properties of gold seem to be the reason why.