Pain in Hands and Feet

[South123]

Had PMR for around 5 years and now on 1.5mg pred withch seems to work fine, almost symptom free. Started getting pain / swelling/ stiffness in both hands and feet. Mild at the moment but still painful. Assuming this is the start of some kind of RA rather than PMR. Wonder if this was masked when taking higher dose of Pred ? Should I try and get a diagnosis or wait until my symptoms are more obvious. Never seen a Rhumi just my GP who has been fine.

[Charlie1boy]

Interestingly enough, I developed pain in hands and wrists when I was two years into pmr, and on 5mg.

Following advice at the time, I increased to 7mg, and the pain cleared up in 24 hours.

Not saying it would be the same for you, as there are so many other alternative possible diagnoses, but that was my experience.

Good luck.

[DorsetLady PMRGCAuk volunteer]

You could try a higher dose for a couple of weeks and see if it makes any difference... but also speak to GP and ask about RA.

[PMRpro Ambassador]

Feet and hands CAN be involved in PMR and they are also common places to develop osteoarthritis so it may not be RA. It is worth trying the flare protocol and see if it solves it as it did for Charlie1boy

[Nextoneplease]

hi, I seem to be having a different experience to Charlieboy. My hands and feet are swollen and painful around the joints (which of course are many). It’s got worse since I started trying to reduce from 7mg to 6.5mg. By chance I had a rheumatology appointment and the rheumy pointed out the bony nodules on my hands, as well as noting the severe shoulder, wrist and foot osteoarthritis shown on previous X-rays.

So, it may not be the same for you… but my rheumatologist is pretty sure that pred has up to now been masking OA pain as well as dealing with PMR pain and inflammation.

Hope you get some clarity and relief soon xx

[South123]

Thanks for the replies. I now have a face to face GP appointment in 2 days so that is good news. Will report back.

[Blearyeyed]

I'd suggest that you ring and get it assessed before you increase the dose.There could be various reasons for the pain and as you say if it is RA or inflammatory/ reactive arthritis, and in some cases even OA a higher steroid dose could mask the symptoms but it would still return when the dose was lowered again. Better to know now what you are working with before it gets more severe.

And of course, you can't be sure if it isn't some other sort of issue like neuropathy or even Anaemia or a vitamin deficiency that would require a different type of treatment to improve the pain.

Only the GP can really assess it.

[Whitner]

South123 I’m experiencing the same thing since I was able to get off prednisone after 5 years! I’ve been off since July. Both of my hands hurt especially when I make a fist. Worse in the morning. I’ve started taking Advil at night and aleve in the morning to see if I can get any inflammation under control. I’ll get some bloodwork done late next month to measure inflammation markers. I kinda feel like it is PMR related since it’s worse around 2AM and gets better as the day progresses.

[AtopicGuy]

Six months after I last came off prednisolone, both my hands swelled up slightly and became stiff. Another six months later, the left one has returned to normal, but not the right. The joints seem fine, and the problem seems to be in the tendons. I cannot quite close the fist, nor straighten fully the three outside fingers. I have tendon nodules in the palm of both ring fingers, but nowhere else. I have read that long-term steroid use can harden the tendons, and my courses have totalled about 3 years in the last 5 years. I'm hoping that my right hand eventually recovers like my left one did, but I'll keep an eye on it. If I get another course of steroids, I'll see whether that makes it better or worse.

[PMRpro Ambassador in reply to AtopicGuy]

That would be typical of an ulnar nerve problem.

[AtopicGuy in reply to PMRpro]

That's interesting, because I felt the bilateral muscle weakness, stiffness and pain spread from my shoulders, down the arms, to just below the elbows, before the hand symptoms appeared; and it eased off as my hands improved. I'm due to see a neurologist next month.

[PMRpro Ambassador in reply to AtopicGuy]

The ulnar nerve is often impinged at the shoulder.

[South123 in reply to AtopicGuy]

That's really interesting. Will definitely bear that in mind when I see my GP tomorrow.