I am 77 years old and I've had PMR for 6 years. I'm now at 2mg. prednisone. (up from .75....ah, I was so hopeful a year ago) and over the last 3 months have been waking up with terrible pain in hand and thumb and wrist. Primary doc sent me for an EMG which showed moderately severe (whatever that means) carpal tunnel. Just like PMR, in the middle of the night it awakens me with burning searing pain and during the day is usable and pretty much ok. I have an appointment with a Hand specialist/surgeon whom I know does not leap straight to surgery and will do what she suggests, either PT or have the carpal tunnel surgery. I hate the thought of a surgery but am grateful for carpal tunnel and not the other dire diseases the EMG could have revealed. Anyone else had carpal tunnel along with PMR? Also good news: the EMG with the needles etc to shock the muscles and nerves was NOT painful. The doctor said women over 70 have no trouble with it nor do young mothers who are glad for the break of lying down for a moment. haha. And she was right. It was not painful just annoyance. Here come the Holidays! Enjoy. I have family coming from Sweden to stay for 3 weeks but thank goodness the kids are bigger and everyone can help! Any advice. I am still jumping in freezing lakes once a week at least and think it helps with inflammation.
update on my wrist pain. : I am 77 years old and I... - PMRGCAuk
update on my wrist pain.
Each to his own ...
Carpal tunnel can be part of PMR - it can be part of the presentation or appears like any other part of PMR when the pred dose is too low.
Do you think if I upped the prednisone (loathe to do..) it would go away without surgery?
It might well. Bcol has a story about CTS appearing with pred reduction - pretty sure an increase sorted it out and it didn't come back with the subsequent return to the earlier dose.
Very interested in this post, and PMRpro's replies as I've been experiencing something similar. Blaming it on osteoarthritis and using my computer mouse too much, although left hand also affected to lesser extent than right. Haven't actually been woken up by pain once I'm asleep, but have been kept awake by it. (Currently at .5 mg, with occasional day of zero - right now usually every three days.)
will keep you posted!!! Will be curious to hear what the next doc surgeon says.... will ask about prednisone etc.
Same here. I blame the computer mouse for a lot of sins. I get on better with the ergonomic kind. I've got one of the vertical kind that reduces the amount of repetitive movement and they are bigger so the hand is in a much more relaxed position. They got it for me at work when I was having trouble with my neck, which it also helped. When I left my job, the elf and safety person had tucked it in my box of stuff, along with some of the other ergonomic items they had bought me.
There is a wrist support for mousing which you can purchase in most computer sections. You just rest your wrist on it and move the mouse as usual. It will move with you. I had carpal tunnel prior to the PMR diagnosis and had to work with it. Worked in a pinch.
thanks but left wrist... and I use touch pad with right fingers. BUT I am left handed so any number of things I do could cause it I suspect!
Happy Christmas yogabonnie. Let us know what you decide. X
I am also 6 years into this PMR journey. However with arthritis I am never pain free. I have it in my hands as well as other places. Orthopedic Dr gave me braces for my thumbs and wrists. They are small and I only use them when they real hurt. I’ve been at 1 mg prednisone a very long time. Sometimes I still have to bump it up a bit. So much for the 2 1/2 year story I heard when this started. I take arthritis strength Tylenol daily and I’m doing ok. I still work at Chico’s women’s clothing a couple shifts a week. I like the discount on clothes.
Hi Bonnie , sorry to hear about your hand pain. I too have developed mild carpal tunnel type symptoms, and wrist and thumb joint intermittent pain. I thought it was arthritis. I have been on 1mg for ages. I was down to 1mg 3 times a week but my shoulders and hips got sore, so I'm sticking with 1mg.
What's causing the wrist and thumb problems? Is it part of Pmr?
Best of luck to you x
I am in Nebraska, between Omaha and Lincoln.
ah, little more than a stones throw away. I'm in Minnesota!
Hey! We’re practically neighbors!
I had exactly the same ‘moderately severe’ result with my EMG. My rheumy took one look at the results and immediately referred me for surgery, which has pretty much resolved the pins and needles and tingling, but 18 months on and I’m still getting occasional shooting pains in the scar area. Before the surgery I was given a night splint to wear, which is pretty bulky and cumbersome, but prevented the symptoms as it prevented my wrist from bending and compressing the median nerve further. The surgery, under local anaesthetic, was fine with no issues at all. You have to be careful during the recovery though, and massage the scar once the sutures have been removed. I have no regrets about having the surgery and I’m much more comfortable at night.
Thanks for this! I do wear the brace at night and still have the pain. dont quite understand that. maybe it is too loose. and My wrist can bend anyway. I did tighten it a lot one night and circulation was stopped and same thing happened. ha. typical!
That exact same thing happened to me! Too loose and the symptoms were still there, too tight and no blood supply! My splint was something Houdini would have struggled to get out of; all Velcro, laces and straps. I was referred for hand therapy and I persevered with the exercises, then when the EMG results came through, my rheumy declared enough was enough and off I went for surgery. My left wrist is playing up now, so like you, I’m awake with pins and needles and numbness, but also pain. I hope you get the help you need and deserve.
Hi Bonnie,
I started to have fingers/hand issue at lower dose of pred, about 2-3mg. It extended my PMR medication for probably 2+ years. I am now 1 year off pred and have issue with painful wrists. I have been seeing hand Dr for last 2 years or so and he decided that it is connective tissue inflammation due to hand overuse and suggested PT. I have weekly PT sessions. One possible reason for wrist pain ( knowing your triathlon background) could be biking and stress it creates on wrist ( something to consider if you are still doing rides over an hour or so). Also what helps is application of local non-steroid patches put overnight on affected area as an alternative to increase of pred.
I just had Rheumatology appointment after being off pred for one year and his opinion is that wrist pain is not connected to PMR because my blood test is normal and I am "cured" - his words not mine :).
Edit: I think impact of PMR on connective tissue is something that I wish there is more research on. I have suffered in first few years of PMR with knee connective tissue problems. Ultimately it made impossible for me to run because of the damage to knee ligaments. My opinion is that weaken muscles create increased stress on connective tissue around joints and eventually something gives in. If anyone know of any study on this subject please post link, I would be very interested.
so interesting. I am fine in the day. it is the night that the pain is fierce ! will try some of those patches.
my PMR started with intolerable left wrist pain which prevented sleeping and resisted all painkillers. Misdiagnosed by GP as carpal tunnel (which I have mildly) and injected, making it worse. Went to a wrist surgeon who mused ‘I think this is vasculitis, not for me…’ and that opened the door to rheumatology and pred - instant relief.
Yes, I’ve got carpal tunnel syndrome. I wear splints at night, & find they help. I guess it’s because I’ve had 4 years of steroids…but my husband had carpal tunnel years ago, & had surgery for it, & recovered very quickly indeed…& was not on any medication at all at that time. I think it’s easy to blame pred &/or PMR for everything, I really do. I’m happy managing mine right now. I have bad OA in wrist & fingers etc, too. It’s hard to know what causes what as I’ve 11 diagnosed diseases right now! Not possible for me to state it’s linked to PMR, mine could be linked to my hypermobility, or not linked to anything…or too much crochet!! S x
About a year ago I had tingling and numbness in my hands at night, waking me up - an early sign of carpal tunnel syndrome. In April 2023 I suddenly developed trigger thumb and severe carpal tunnel - pain, weakness, swelling, tingling. A shot of cortisone in my thumb helped the trigger thumb, and I was considering surgery for the CTS. I started wearing splints on both hands at night. In the summer I developed hip and shoulder pain and stiffness, diagnosed as bursitis. WIth some help from PMR pro, I faced the possibility of this being a flare, and increased prednisone from 3.5 to 10, in combination with NSAIDS (Aleve). Over time the hip and shoulder pain stopped and the CTS now is very very mild.
have had corticosteroid injections for three years in both wrists, pain level of about 8 dropped to about 1-2, and pain in feet, dx'd as OA, also greatly diminished. was able to hike in rocky mountains w/o pain or nausea for full month. recommend injections before getting surgery for CT, some recover easily w/ good outcome, others significantly less so. Wrist braces at night help, injections about q4mos. Also take varying dose of pred, 3-7 mg,off and on, due to conflicting advice from four different MDs. All want pred stopped, sying side effects not worth the risk, they have not had PMR!
"All want pred stopped, sying side effects not worth the risk, they have not had PMR!"
You can say that again!!!
Thanks. I am thinking I will ask about the injections first. Have no idea how many people this hand specialist has seen with PMR but I suspect a good amount..so perhaps she knows something about it. thanks for the info. I might raise my prednisone for a week or so now that I have company coming for Christmas... if I dont get more than PT! thanks
hi yogabonnie
Sorry to hear about your issues its sounds so painful and . Having to increase your pred . It’s so frustrating sometimes. I was on 1 mg all last last year but has to increase to 2 mg in January. I’m just starting another reduction now so fingers crossed. I haven’t had CTS but both my thumbs are numb on the tips. Since last May. Weird!! I’ve had them checked and blood tests etc. and been given folic acid for 3 months! But no improvement. I have an appointment in December with GP so see what gives. Also I hear a pulsating sound in my head , I suffer with tinnitus which gets more intense sometimes.
We tend to blame PMR for most things so it’s good that we get things checked out xx
Hats off to you for jumping in a freezing lake .but it’s so good for you xxx I have trouble trying to turn the shower to cold ❄️❄️❄️❄️
Carole
Thanks for your response!! I think turning the shower to cold is MUCH harder than the lake or just cold water in the tub! something about being PELTED with it. No!!! I just had cortisone shot in thumb joint yesterday we shall see! Im fine today but thumb still locked up.
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