Grip Strength

[NCStateLine]

Hi - started at 20 after diagnosis in January of 24 and my reductions were as follows - each after 4 weeks and a rheumy visit 20 -15 -12.5 -10 - 7.5 -6.25 -5– 4.5-4 and most recently to 3.5. When I went to 4 I noticed a bit of hand swelling and loss of grip strength. Now at 3.5 I notice it a lot. I have OA in a thumb and use Voltaren and that helps. When I told the Rheumy about the hands he checked them out and said RA was a possibility and asked history. We agreed to wait and see what occurs next. Clearly next is this is a bit worse. The other symptoms seem to be OK - nothing close to when we started in January. Biceps / triceps have felt like I worked out the previous day a lot of the time but no real difficulty and not new - glutes and thighs seem fine.

any thoughts or suggestions? My gut is saying hang at 3.5 and start skipping the monthly decrease…..

Thanks very much

[PMRpro Ambassador]

I'm sure you must know by now - we don't like that taper approach!!! It was not too bad down to 10mg but then all the guidelines say 1mg at a time!! But you have survived it. Probably.

When you say "The other symptoms seem to be OK - nothing close to when we started in January. Biceps / triceps have felt like I worked out the previous day a lot of the time but no real difficulty and not new - glutes and thighs seem fine." it makes me prick my ears up because really - if you were OK at the starting dose, you should STILL be OK at the current dose if it is enough to manage your inflammation. You shouldn't feel worse at the end of a taper step than at the start.

Did any of the symptoms worsen even at the same dose? I'd be inclined to use the flare protocol and go back to 4mg and see how that fares over a couple of months. To get from 20 to under 5mg in 8 months is pretty fast - median time 15 to 5 is 18 months, You are well ahead of the curve even with a slightly crazy reduction plan - we don't say the lower the slower for nothing!!!

[DorsetLady PMRGCAuk volunteer]

I’d stay put for now… but just be aware triceps/biceps could be PMR grumbling so do monitor - and make sure it doesn’t become more often. Also maybe have a look at carpal tunnel syndrome re wrist/hand

orthoinfo.aaos.org/en/disea...

.. and agree very fast taper., you need to slow down,

[NCStateLine in reply to DorsetLady]

Thanks - it’s really kind of an odd thing. When I first wake up the hands are weak and sore but after a few hours after taking pred - things get maybe 80% better. I think I will take a break on the reductions and hopefully things settle. Appreciate the help

[PMRpro Ambassador in reply to NCStateLine]

That sounds a bit carpal tunnel-ish. It is caused by swelling due to inflammation in the tunnel the nerves pass through in the wrist. The pred reduces the swelling and the symptoms improve. Speak to your GP about it.