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PMR with hand/wrist pain and swollen veins?
Polymyalgia Rheumatica (PMR) | Last Active: Jul 3, 2023 | Replies (32)Comment receiving replies
Wrists, thumbs and hamstrings: PMR diagnosed November 2121, just after my 82nd birthday. Prednisolone 15mg daily now tapered to 7mg. Over the past 2 months of tapering Pred, PMR pain extended from shoulders to wrists and thumbs. Over the past month pain has extended to knees/hamstrings. Quite symmetrical. The primary symptom is pain, worst in the mornings, reducing after Pred. Physically, I can do most things I used to do in 2121, though at a lesser level of performance. For example, I can run a couple of kilometres at 6 minute per km pace or dig a garden for an hour. But the pain level is increasing and the extension to shoulders and arms and knees is worrying. I have an appointment tomorrow with PMR specialists at Flinders Medical Centre (Sth Aust) where I will ask for advice on whether it’s necessary to continue tapering. At present, I’m inclined to the view that Pred is less of a threat to continuing functionality than PMR. I am physically fit, exercise daily, and existing Pred dose has not caused any of the usual complications. No weight gain, &c
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Continuing from preceding comment…..
Advice from my rheumatologist:
1. Inflammatory markers normal over recent months.
2. Continue monthly 1mg tapering from current 7mg to 2 or 3mg daily. Return for assessment in 4-6 months.
3. Wrist and knee pain suggests incipient rheumatoid arthritis. These symptoms are not a usual consequence of PMR but PMR is often a precursor to RA. My current absence of joint swelling, soreness to touch or loss of joint mobility may only mean that these symptoms of RA are masked or avoided by my current high 7mg daily Prednisolone dosage.
4. These RA symptoms/afflictions may develop as I continue to reduce Prednisolone dosage.
This was bleak advice. Rheumatologist justified it on two grounds:
1. As a healthy 82 yr old with a 5-10 year life expectancy continuance on Prednisolone at anything above 2 or 3 mg daily dosage will result in a range of serious effects, disabilities, miseries. Complete elimination is best;
2. If Rheumatoid Arthritis does develop, there are better therapies than Prednisolone.
As a matter of interest, I also have a relatively benign form of Dupuytren’s contracture. Together with PMR, this is a double whammy for my rogue Scandinavian genes. Other than the Scandinavian connection, PMR and DC seem to be unrelated conditions.