Are painful swollen hands and fingers a PMR flare?

Posted by deborahinmaine @deborahinmaine, May 15, 2024

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!

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

Have you had any discussion with your rheumatologist regarding the concern that your PMR is progressing to Rheumatoid Arthritis? That may be a good conversation to have if your hands and wrists continue to be painful.

REPLY
Profile picture for carenr @carenr

i was diagnosed with PMR last april, 2024. Was on Preg. 15 mg until Feb, 2025 , and at the same time in Oct. 2024 was put on Methotrexate. In April, my wrists were on fire. The rheumatologist says i have Rheumatoid Arthritis now and put me on low dose preg, and Leflunomide and i am still on the Methotrexate. My blood tests showed negative for RH.
This is getting confusing. has anyone else had these symptoms? thank you

Jump to this post

I had wrist and hand pains develop while tapering when I got down to about 7. They continued off and on until I was down below 2. The diagnosis (X-ray) was osteoarthritis that had until then been kept in check (no pain) before PMR by my natural sufficient production of cortisol.
I have been off prednisone now for over two months…no pains. Evidently the cortisol factories are back in production.
Hang in there. Try to keep reducing. If you can deal with some pain while your adrenals resume production, everything might clear up. Otherwise you will be forever reluctant to part with the prednisone. Good luck.

REPLY

I am just down to 7 mg and out of the blue the back of my right hand turned a bit pink, slightly warmer than the left hand and swelling. My acupuncturist noticed it. My finger joints don't hurt, my knuckles don't either, just feel a little stiff, but the back of my hand from the knuckles down to the wrist are somewhat swollen and hurt somewhat to the touch. The swelling subsides during the day but is back when I first wake up. I just saw the rheumy a week ago and all was fine and my blood tests, he said, were perfect. Do I do anything besides wait this out?

REPLY

I'm on 15 MG prednisone daily, down from 20 MG about three months ago. All my PMR symptoms are gone except for my hands, which feel puffy and stiff every morning. I started taking 12.5 MG in the morning and 2.5 MG in the late afternoon, and that helped. But the hand issues are still there, to be sure. I'd describe the pain/discomfort as the feeling you'd get from using garden clippers all day - that kind of soreness/stiffness.

I did an epsom salt bath/float about a week ago and felt better than I have felt in months. It really seemed to bring down the swelling/puffing. I'm a 69 year-old, physically active male, BTW.

I hope you feel better. The one thing I've noted about PMR is that physicians tend to look for almost anything else first - rotator cuff, carpal tunnel, etc. It's not helpful, but I guess they have to rule things out first.

Again, best wishes for good health.

REPLY

I have had hand or wrist problems three times with the pmr . Swollen hands/fingers led to xrays two different times. Xray images revealed some osteoarthritis and cppd arthropathy .
Both times the rheumatologist upped the prednisone dose. Methotrexate was suggested on a few occasions, also hydroxychloroquine. I was not interested in taking either of those drugs. Upping the prednisone dose to the last dose where I did not have a problem worked for me.

REPLY

My hand/ wrist problems started about 2 yrs into my PMR while tapering off prednisone and starting Kevzara. Wrist pain started first and was so bad I could not lift my grandsons😥. Kevzara eventually made wrist pain tolerable, then hand pain started…no grip strength and lots of painful trigger fingers. My rheumatologist diagnosed RA by feeling my swollen knuckles. Continued the Kevzara and RA went into remission (Rheumatologist diagnosed via knuckles & reduced pain), but still have grip strength & triggering issues. I added turmeric to my diet, did PT for grip/trigger and that helps grip, pain and triggeringdramatically . I suggest you work with rheumatologist…journey is a bit rough but hopefully things will get better for you

REPLY

Yes I do. Been off Prednisone since May 15 - by mid June my right hand is swollen very sore stiff in the morning at least till mid day. very stiff cannot even hold pencil in the morning. cannot bend my fingers all day.. usually soak my hands with paraffin oil, take 2 paracetamol daily and cream for pain... the ultrasound says osteoarthritis.
not much relief though. Doing more blood tests RA cortisol . Also do not feel well , general low feeling.
When does this end? Any suggestions?

REPLY

Is there bloodwork you can do to test for interleukins to see if a specific one is causing this reaction?

REPLY

Hand pain and stiffness was my 1st and most significant symptom and is the most persistent

REPLY

Polymalgia then developed Giant cell Arteritis. Been on steroids for two and a half years but after gradually reducing dose three months later got chronic fatigue and all joints ache

REPLY
Please sign in or register to post a reply.