1. < Polymyalgia Rheumatica (PMR)

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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pmrsuzie | @pmrsuzie | Jun 29 10:06pm
In reply to @wilmingtonemperor "Mary, Doc put me on Meloxicam on Tuesday for the pain and stiffness in the hand..." + (show)
@wilmingtonemperor

Mary, Doc put me on Meloxicam on Tuesday for the pain and stiffness in the hand and wrist. Non-steroidal anti inflammatory. Described it as a little mallet as opposed to the big hammer of prednisone. By Thursday no more pain or stiffness. But, is an NSID and have to watch for internal bleeding and no alcohol 🍺.

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I'll have to read about Meloxicam. Are you only taking it when you're experiencing pain? I hope it keeps working for you.

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1 reply
wilmingtonemperor | @wilmingtonemperor | Jun 30 8:49am
In reply to @pmrsuzie "I'll have to read about Meloxicam. Are you only taking it when you're experiencing pain? I..." + (show)
@pmrsuzie

I'll have to read about Meloxicam. Are you only taking it when you're experiencing pain? I hope it keeps working for you.

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Taking it in the morning AFTER breakfast daily. 15 mg tablet. Today is day 5. It is not a new drug.

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art43 | @art43 | Jun 30 9:56am

I continue to taper from a high of 30 last October. In January, at 9, my PMR was determined to be in remission by testing. My rheumy made it clear at that time that various pains should be expected as the taper continued, but that they would not be PMR, but probably osteoarthritis. I am now at 4, and variously and randomly experience low levels of pain and stiffness in one shoulder, wrists, hands, and lower back, all normally largely gone by late afternoon. Mild osteoarthritis was confirmed in my wrists and hands by imaging. As I continue to taper at 0.5 per month, I expect these to continue until my cortisol production improves. In the meantime an occasional dose of Tylenol, and gentle stretching has been helpful. Since NSAIDS are a no-no while on prednisone, I look forward to being able to try them if necessary once off prednisone. In any case, I have not been tempted to increase prednisone to control what have been manageable symptoms, knowing that they are not PMR, and hoping all this will be gone within the next 8 months. We shall see. Best to all.

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2 replies
DadCue | @dadcue | Jun 30 10:06am
In reply to @art43 "I continue to taper from a high of 30 last October. In January, at 9, my..." + (show)
@art43

I continue to taper from a high of 30 last October. In January, at 9, my PMR was determined to be in remission by testing. My rheumy made it clear at that time that various pains should be expected as the taper continued, but that they would not be PMR, but probably osteoarthritis. I am now at 4, and variously and randomly experience low levels of pain and stiffness in one shoulder, wrists, hands, and lower back, all normally largely gone by late afternoon. Mild osteoarthritis was confirmed in my wrists and hands by imaging. As I continue to taper at 0.5 per month, I expect these to continue until my cortisol production improves. In the meantime an occasional dose of Tylenol, and gentle stretching has been helpful. Since NSAIDS are a no-no while on prednisone, I look forward to being able to try them if necessary once off prednisone. In any case, I have not been tempted to increase prednisone to control what have been manageable symptoms, knowing that they are not PMR, and hoping all this will be gone within the next 8 months. We shall see. Best to all.

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Your rheumatologist sounds sensible to me. Better than people who advise increasing prednisone for niggles of pain as we are trying to taper off prednisone. My rheumatologist also said I shouldn't expect to be completely pain free.

It is incredible that my rheumatologist says I can still take Prednisone if I need to after so many years of trying to taper off Prednisone. It isn't like Prednisone has been banned and I will never be prescribed it ever again. Knowing this also makes it easier to taper off Prednisone. I actually have a prescription for Prednisone to take "as needed" for unexpected flares when I travel.

That reminds me ... NSAIDS were contraindicted when I was on both Prednisone and warfarin. It would probably be okay it I wanted to take an NSAID now because I'm no longer taking Prednisone and warfarin.

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pmrsuzie | @pmrsuzie | Jun 30 10:48am

A couple days this past week I took 4.5 mg instead of 5 but yesterday and today I took the 5 mg. Getting my markers tested tomorow, hoping for normal results. My dilemma now is whether to stay on 5mg til Aug appt or alternate back and forth with 4.5 for awhile.
Thanks for the input from everyone here with their experiences. I guess my goal is to get off pred without having to take another med except reasonable amount of Tylenol

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1 reply
dlb3 | @dlb3 | Jul 1 8:54am
In reply to @art43 "I continue to taper from a high of 30 last October. In January, at 9, my..." + (show)
@art43

I continue to taper from a high of 30 last October. In January, at 9, my PMR was determined to be in remission by testing. My rheumy made it clear at that time that various pains should be expected as the taper continued, but that they would not be PMR, but probably osteoarthritis. I am now at 4, and variously and randomly experience low levels of pain and stiffness in one shoulder, wrists, hands, and lower back, all normally largely gone by late afternoon. Mild osteoarthritis was confirmed in my wrists and hands by imaging. As I continue to taper at 0.5 per month, I expect these to continue until my cortisol production improves. In the meantime an occasional dose of Tylenol, and gentle stretching has been helpful. Since NSAIDS are a no-no while on prednisone, I look forward to being able to try them if necessary once off prednisone. In any case, I have not been tempted to increase prednisone to control what have been manageable symptoms, knowing that they are not PMR, and hoping all this will be gone within the next 8 months. We shall see. Best to all.

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I wish you well in your journey. I am prednisone free almost two weeks. I was on prednisone for eight months . Initially 60 mg were prescribed for me because I also had GCA and PMR. Following anti-inflammatory diet for several months now recently added some stretching exercises. And switched from Tylenol to ibuprofen to manage any PMR or tapered down pain that I might have. I want to have my cortisol levels tested so I will contact my endocrinologist soon. Hoping the adrenaline gland is not suppressed too much and insufficient. So far so good.

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pmrsuzie | @pmrsuzie | Jul 1 9:55pm
In reply to @pmrsuzie "A couple days this past week I took 4.5 mg instead of 5 but yesterday and..." + (show)
@pmrsuzie

A couple days this past week I took 4.5 mg instead of 5 but yesterday and today I took the 5 mg. Getting my markers tested tomorow, hoping for normal results. My dilemma now is whether to stay on 5mg til Aug appt or alternate back and forth with 4.5 for awhile.
Thanks for the input from everyone here with their experiences. I guess my goal is to get off pred without having to take another med except reasonable amount of Tylenol

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CRP was elevated. 7.5
Normal is less than 5
Guess I'm staying at 5 mg til Aug appt
Only problem seems to be Achilles tendonitis, not pmr

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pb50 | @pb50 | Jul 4 1:54pm
In reply to @tuckerp "I am not to familiar with diagnosing RA. When I had my initial blood work done..." + (show)
@tuckerp

I am not to familiar with diagnosing RA. When I had my initial blood work done after self diagnosing myself. Rhumy pulled . ESR , CRP, HS-CRP, RA, and CCP(IgA,IgG). My tests were all negative so ruled out RA. Would that be a fair assessment.

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Probably so if you were in a particularly acute phase when inflammation markers should pop. The lack of positive result for RA Factor means nothing. About 50% of RA patients are sero-negative. I was for 7 years. But i would be surprised if your ESR wasn't elevated for either RA or PMR.

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