Having been an avid reader of this amazing forum for the last 18 months, I am convinced that a lot of the pain I was suffering before starting on Prednisolone was due to bursitis. I had 13 months of symptoms which included, I’m now sure, bursitis in my hips, shoulders and knees.
I started on 15 mg Pred in August 2022 and was amazed at the impact. All the stiffness and general pain went, even the bursitis in my hips - such a relief! There was just a lingering dis-ease in my left knee. Over the last 18 months this has improved to some extent but never gone away completely and is sometimes worse that others. It doesn’t seem to be related to how much Pred I’m taking. Out of the blue, in January 2023, I started with pain in my right wrist (not one of my original symptoms). By May it was so bad that I could hardly write or pour a cup of coffee!! This has improved but I cannot weight bear, ie place my hand on a flat surface to push myself up. Now, a year later, my left wrist is beginning to show similar symptoms. I’m putting this down to bursitis also.
So, after this long winded introduction, my question is: Is bursitis incidental to PMR or is it indicative of PMR activity rising and therefore a flare? Having been following DSNS tapering to 2mg, I am reluctant to taper further if I am just deluding myself into thinking PMR is on its way out.
Thanks in advance to all you knowledgeable folk out there
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Sukydee
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Some people do get wrist pain with PMR or it could be something like carpal tunnel syndrome but that in turn can be caused by arthritis in the wrist. This might be a useful site.
Do you have any other pains of your PMR or is it just your wrists alone? You are on 2mg and only 18 months in from the start so it could be that you are having a flare brewing up. Have you tried a few days at 5mg? I think ideally you need a physical exam.
Would agree with SnazzyD regarding a flare… 18 months is not that long in PMR terms. And no matter how you reduce, if you go below the dose your PMR requires, you go below it…
..and for many bursitis is part and parcel of PMR.. and that your original symptoms were a combination of both.
If it is a flare, then this contains advice of how to treat it - and maybe return to 3mg rather than 2mg once under control -
Interesting. I was two years into pmr, and tapering nicely down to about four mg, when pain struck in my wrists. Following advice from the Forum, I increased my pred dose by three mg, and the pain cleared up in 24 hours and did not return.
I’ve noticed from other posts that wrists/hands do not necessarily kick in with pain at the outset of pmr, but have developed after a year or so. Yes, it could be carpel tunnel syndrome, but, if it was me, I’d be trying a bit more pred first and see if that works for you.
Like the others - I'd try the flare protocol and see if it improves the problem. If it doesn't or it then returns as soon as you go back to the last good dose, I think you need a discussion with your doctor because either it is something else - and an x-ray might show if it is osteoarthritis - or you are flaring and have gone too low on your dose. Which really, is very likely after only 18 months.
During my first few years of PMR, carpal tunnel pain would occur in my wrists if I overused my hands, such as weeding or picking up heavy objects. I would stop using my hands for a while and the pain gradually went away. I have not had those pains as much when I was able to reduce prednisone under 3 mgs. I am now at 1/4th pred with no pain. I did have hip bursitis which has lessened after hip replacement. Before that op, I had yearly steroid shots in the hip.
Thank you everyone. The only original symptom I have is the pain in the left knee. The wrist pain was a new symptom that started a year ago. I did mention the pain in my right wrist to the rheumatologist, when I saw him in July, but he didn’t think it was of any significance and told me to continue tapering at 1mg every two months. As advised, I will treat it as a flare and increase the Pred. Thanks again.
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