I had my third face to face consultation with Rheumatologist this week and 2 things were decided which might be of interest to others with the same problem.
1) We discussed the continueous pain in my right hand, after a thorough exmination of joint movement in fingers, thumb and wrist, he ruled out Carpal Tunnel and thinks the problem is with the tendons rather than the muscles, he is arranging for an Ultrascan to investigate further, I have previously had an X-ray, so now waiting for Ultrascan appointment.
2) After a general discussion about the state of my PMR and complimenting me on how I have managed to get down to 3.5mm of Pred, I told him I was following a Slow Tapering Schedule (thank you DL ). He then asked me if I was prepared to "have a go" at increasing Methotrexate from 15mg per week to 17.5mg per week !!! coupled with an increase from 5mg to 10 mg of Folic Acid, 5mg day before Methotrexate and 5mg day after Methotrexate, with Blood Tests every 4 weeks.
He thinks this new arrangement may make further reductions in Pred easier. After reading so many posts on here where people struggle at these low levels of Pred I agreed to give it a go !!!!!
I am to ring him at anytime if I have Problems/Side Effects with this arrangement
Only time will tell, I will post an update in a couple of months
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Golf-1
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Had Ultascan on both hands yesterday, I guess so they could compare the two hands as only have pain in Right Hand.
After a very thorough scan on both hands that took about 20 minutes with the operator appearing using lots of gell and taking lots of pictures, I asked "can you see what is causing the pain?" the answer from the operator and an overseer who was sitting in the room looking at a seperate screen was "Yes"
No further information was given except that a full report would go to my Rheumatologist within 10 days.
At least I now know the pain is caused by something that is recognisable, hopefully that will lead to some sort of treatment to stop it.
Will update further after I have heard from Rheumatologist.
I have received a copy of the ultra scan report as below, I am waiting to hear from my new Rheumatologist, unfortunately the original one who I had complete confidence in, retired from NHS last week!!!
There is some technical stuff in the report and they use the word "Moderate" thank goodness it is not severe !!!!!
I assume you mean I am not managing it well, which is probably true !!!!
Any advice on how best to manage it would be very much appreciated. Not using the hand is not really an option, I do not like taking pain killers.
I am prepared to wear some form of support if that works, I would not know where to start as there seem to be so many different types ? and I will buy and apply Gell if that works, any recommendations?
No, not you - the medication!!! You need enough medication to manage the level of inflammation present. As I say so often - not enough doesn't work as the left-over inflammation builds up over time. Using your medication optimally stops the inflammatory cause of the pain at source.
I went back up to 8mg of Pred a couple of weeks ago, and am now back at 4mg. shoulder and neck pains seem to be under control at this level so I intend to stay at 4mg for a month or so, or would you suggest I go back to 5 or 6mg for a while?
Whatever level of Pred I have been on has not relieved the pain in right hand so hoping the Rheumatologist has got some answers, I am apparently on the new Rheumies waiting list.
I saw my new Rheumy today and pleased to say that he also is very thorough, unrushed and simpathetic.
He went thorugh the Ultra Scan results and confirmed the pain I have is caused by inflamed tendons, he was suprised I did not have more pain in my wrists , but I don't ? he was also suprised I do not have pain in my hand/wrist joints, but I don't.
He was not able to say what is causing the inflamation, he was not sure that it is caused by PMR but is not ruling it out.
As it is an inflamatory problem, not relieved by Pred in any way, we have agreed I should increase MTX to 20mg a week with blood test in 4 weeks and review in 3 months.
He did suggest an injection of some sort into the hand, and/or painkillers might help, but I am choosing not to go down that route at the moment.
Not really much help to other "Hand Pain" sufferers I am afraid
I'm surprised tendinitis isn't relieved at all by pred - maybe you weren't on enough. But then, I don't think my achilles tendinitis was improved by pred either
The MTX won't have any effect on the return of adrenal function and that is likely to be a limiting factor from here on. But it is up to you and I hope it works.
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All in my mind, apparently!!!
1st Rheumatologist appointment and instructions etc. 
Update on where I am on the great PMR journey
Update on wait for dexa scan 
Recieved rheumatologist letter and conclusion
