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!

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

@abbeyc

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?

Jump to this post

I don't think PMR "causes" osteoarthritis (OA) or inflammatory arthritis.

PMR might make arthritis worse if you already have arthritis. Given that people are older when they are diagnosed with PMR, I think most people with PMR have some arthritis.

I don't think prednisone prevents the progression of any type of arthritis.

Prednisone reduces the inflammation and eases the pain but I don't think prednisone prevents anything.

A sustained remission of PMR is difficult to achieve with prednisone. Some people say a "new batch of inflammatory substances are released every day" --- that doesn't sound like remission to me.

These are my opinions for what they are worth.
--------------------------------------
Inflammatory arthritis is different compared to osteoarthritis (OA). The "damage" that is caused by both inflammatory arthritis and osteoarthritis will eventually look similar but maybe more severe in the case of inflammatory arthritis. However, osteoarthritis can be severe too.

PMR doesn't help inflammatory arthritis or osteoarthritis. Having any type of arthritis with PMR shouldn't be allowed in my opinion!

REPLY
@jiffaw

My PMR first started manifesting in my hands and wrists on New Years Day. Everyone thought it was carpal tunnel but it was bilateral and then it spread. I had no strength and couldn’t close my hands. It soon went to my biceps, then shoulders & hips etc. Soon I couldn’t do anything! I was started on 15 mg. of prednisone and methotrexate. I’ve since titrated down to 5.5 mg prednisone daily and take 20 mg methotrexate once a week. I can slightly feel PMR in my hands and wrists but I can deal with it and try to ignore it - keeping busy in my garden.
I fall asleep every time I sit down.
I want to get off prednisone because it gave me type 2 diabetes! I’m extremely strict with my diet and have gotten off insulin. It’s also affected my teeth and I’m sure my bones are under attack. My rheumatologist wants me to go on kevsara, but I’m not wanting to be on an expensive drug that I have to stay on for years! My hair is thinning from methotrexate.
I think the doctors just experiment on us with all of these dangerous drugs that carry their own list of warnings of life threatening conditions that just cause us even more issues. I was very healthy and then something suddenly went wrong and caused my body to start attacking itself and I want to know what that is!

Jump to this post

I am tapering my prednisone dose and am now down to 5mg . My rheumatologist wants me to stay there until I see him in October. I'm taking it because I have Giant[Large] Cell Arteritis, a complication of PMR. I also have a weekly injection of Actemra. But, like you I developed Type 2 diabetes . I was not impressed. I could not tolerate Metformin[ I was hospitalised] so I have been having insulin. Now I have just been told that I can stop the insulin which delights me. Like you I have been fairly strict with my diet , I have lost 6 kgs but always wonder what is next going to happen due to prednisone. I see my ophthalmologist next week because all this drug taking has been to save my eyesight.

REPLY
@jlo2252

Any minor illness causing a flare sounds like reactive arthritis. That’s usually how it works but I would ask your rheumatologist about that. I have been very lucky that I have had some good doctors taking care of me.

Jump to this post

Not any minor illness - specifically, any infection can trigger reactive Arthritis.

REPLY

I had similar hand problems after a year of PMR, without having taken prednisone.

REPLY

Do you continue to have pain in yr hands?

REPLY

I'm not a doctor but from what I've been told by my Rheumatologist and what I have read, you probably should have been started on 20 mgs of Prednisone right off the bat. It may be a little of both, but not sure if osteoarthritis causes weakness in hands. That sounds more like a PMR symptom.

REPLY
@marymullins7

I had similar hand problems after a year of PMR, without having taken prednisone.

Jump to this post

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 🍺.

REPLY
@joan7

I'm not a doctor but from what I've been told by my Rheumatologist and what I have read, you probably should have been started on 20 mgs of Prednisone right off the bat. It may be a little of both, but not sure if osteoarthritis causes weakness in hands. That sounds more like a PMR symptom.

Jump to this post

And an RA thing…

REPLY
@formerpaa70

Do you continue to have pain in yr hands?

Jump to this post

No, the pain moves around, as it has from the beginning. The original hip pain is almost gone, the shoulder pain is much less, knee pain gone completely, hand pain sometimes returns. Right now it’s in my back and ribs, which is awful, but is getting better. I don’t know what to expect next, but I never wish I had taken prednisone.

REPLY

Looking at the side effects of Prednisone per Mayo Clinic, I'm now wondering if it's your osteoarthritis and/or a recurrence of the PMR. I also had pain/stiffness in my hands and now that my Prednisone is reduced to 2 and 3 mgs every other day, my symptoms are coming back. Here's a list of side effects from Mayo Clinics website, but keep in mind there are always exceptions to the rule:

Side effects of corticosteroids taken by mouth:
Corticosteroids that you take by mouth affect your entire body. For this reason, they are the most likely type of corticosteroid to cause side effects. Side effects depend on the dose of medication you receive and may include:

A buildup of fluid, causing swelling in your lower legs.
High blood pressure.
Problems with mood swings, memory, behavior, and other psychological effects, such as
confusion or delirium.
Upset stomach.
Weight gain in the belly, face and back of the neck.

When taking corticosteroids by mouth for a longer term, you may experience:
Problems with the eyes, such as glaucoma or cataracts.
A round face, which is sometimes called moon face.
High blood sugar, which can trigger or worsen diabetes.
Increased risk of infections, especially with common bacterial, viral and fungal
microorganisms.
Bone fractures and thinning bones, called osteoporosis.
Fatigue, loss of appetite, nausea and muscle weakness.
Thin skin, bruising and slower wound healing

I hope this helps you and somehow you can get answers to your issues very soon.

REPLY
Please sign in or register to post a reply.