Are painful swollen hands and fingers a PMR flare?

Posted by deborahinmaine @deborahinmaine, May 15 11:56am

I got off prednisone for PMR after almost 3 years in April. In February I had woken with swollen painful hands and fingers. Because of how I sleep it was diagnosed unseen as carpal tunnel. Finally saw my rheumatologist and she thinks it could be a PMR flare,didn’t look like carpal tunnel. That makes sense to me but she has put me back on only 3mg. of prednisone. I have no strength in my hands and can’t make a fist. Very limited in what I’m able to do.
When first diagnosed with PMR and in terrible pain this same rheumatologist started me on 5mg. of prednisone which did nothing.
Finall got up to 20mg. And got some relief.
Has anyone else had issues with your hands during or after being on prednisone for PMR? I also just found out there is osteoarthritis in my hands.
Thanks!

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Don’t know exactly what you mean by “any minor illness” can cause a flare of your PMR. But I should clarify my response to you. Infections anywhere in your body (like eyes, UTI’s, Bronchitis, Pneumonia) can trigger a flare in reactive arthritis—I don’t if this can happen with PMR.

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I guess I should clarify that arthritic pain that accompanies any infection in your body is not always a “major flare”. I might experience minor joint issues that don’t require any additional medication. And sometimes I won’t have any joint pain at all! The instances of pain with infection have been less frequent as I have gotten older. I still get stand alone osteoarthritis or inflammatory arthritis pain.
Now I have been dealing with the pain from PMR for the last two years—I’m currently on my 2nd flare up of PMR.

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To anyone here who has had pain so extreme that it effects your daily routine, yes, injections into the joint can give you relief for a couple of months. I had a couple in my shoulder when I was diagnosed with “rotator cuff” over the last few years. And I will NEVER do it again because that injection was more painful than my shoulder was!! I’m not afraid of needles or injections normally, but I won’t do that again— I’ve been offered them but now I turn them down!

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@jlo2252

I guess I should clarify that arthritic pain that accompanies any infection in your body is not always a “major flare”. I might experience minor joint issues that don’t require any additional medication. And sometimes I won’t have any joint pain at all! The instances of pain with infection have been less frequent as I have gotten older. I still get stand alone osteoarthritis or inflammatory arthritis pain.
Now I have been dealing with the pain from PMR for the last two years—I’m currently on my 2nd flare up of PMR.

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"I still get stand alone osteoarthritis or inflammatory arthritis pain. Now I have been dealing with the pain from PMR for the last two years."

Inflammatory arthritis leads to osteoarthritis. I'm pretty sure PMR over time does the same but not overnight.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638313/
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@jlo2252

To anyone here who has had pain so extreme that it effects your daily routine, yes, injections into the joint can give you relief for a couple of months. I had a couple in my shoulder when I was diagnosed with “rotator cuff” over the last few years. And I will NEVER do it again because that injection was more painful than my shoulder was!! I’m not afraid of needles or injections normally, but I won’t do that again— I’ve been offered them but now I turn them down!

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Agree 100%.
Injection was a nightmare.
Never again

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@jlo2252

To anyone here who has had pain so extreme that it effects your daily routine, yes, injections into the joint can give you relief for a couple of months. I had a couple in my shoulder when I was diagnosed with “rotator cuff” over the last few years. And I will NEVER do it again because that injection was more painful than my shoulder was!! I’m not afraid of needles or injections normally, but I won’t do that again— I’ve been offered them but now I turn them down!

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My orthopedic Dr. said he discourages the cortisone shots. I see many have them done. My Dr said you can only do about 2 of them before you start to damage the joint. He prefers the stem cell. Of course those are $400. But when I researched it, it appeared that stem cell might be just as effective.

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@formerpaa70

Agree 100%.
Injection was a nightmare.
Never again

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The acute pain of the steroid injection was worse than the chronic pain of arthritis. I was glad when the injection was over and done.

My rheumatologist said a localized steroid injection would be better than systemic oral prednisone. I was never convinced. I said it was much easier to increase my prednisone dose.

I had so much joint damage and scar tissue, it was hard for anyone to get into the joint space to do the injection. An ultrasound guided injection was better but I still preferred to increase my prednisone dose.

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@abbeyc

I’m curious. Did you test positive with lab work for RA and have all the symptoms?
Each time I get tested it’s negative. So far we thought it was PMR but the new pain in my wrists, hands, fingers makes me wonder.

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I had elevated inflammation markers like SED Rate but I was Sero Negative for RA factor for 6 years. There’s not much typical about my RA except that i am responsive to anti-TNF drugs like Humira, Enbrel, Remicade.
Thats why there was a question at onset anout my diagnosis.
Today i am inexplicably RA Factor positive. But I rarely have Finger swelling to any extent - just inside the joint that is painful. I have had four trigger fingers - three released. Im fairly well controlled - tho as I write this my Sed rate is elevated. My hands are screaming at me.
Its a journey for sure

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@prestol

I did not have hand pain early in my PMR treatment. That was five months ago at 30-40 mg pred. As I tapered down, the hand pain (no swelling) appeared. My rheumy didn’t have much to say, but the orthopedist I just saw felt it was “inflammatory” rather than OA. He said that pain across the first (large) set of knuckles is usually from an inflammatory process, but if the pain was in the smaller two sets of joints along the fingers, it would most likely be due to OA. Does this make sense to anybody? I have also had cramping (spasms) in my fingers and thumb at times, and wrist pain.

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The most distal joint (the DIP joint) is virtually always osteo. I would challenge that the middle joint is usually osteo. But I do agree that the most common hand joints to be involved are the knuckles.

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@dadcue

"I still get stand alone osteoarthritis or inflammatory arthritis pain. Now I have been dealing with the pain from PMR for the last two years."

Inflammatory arthritis leads to osteoarthritis. I'm pretty sure PMR over time does the same but not overnight.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638313/

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Your comment: Inflammatory arthritis leads to osteoarthritis. I'm pretty sure PMR over time does the same but not overnight.I'm pretty sure PMR over time does the same but not overnight.

does PMR cause osteoarthritis even if the inflammation is being controlled by steroids?

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