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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@szf10

Hopefully the hand doctor you are going to see will schedule an EMG test to rule out carpel tunnel. After my PMR diagnosis and was put on Prednisone, I noticed my hands swelling while I slept and did not get better until hours after my morning dose of Prednisone,which I found odd but was happy for relief. But aside from seeing a rheumatologist, I went to a neurologist for second opinion and he sent me for the EMG. I needed to rule out carpel tunnel (which the test did) and be sure I was being treated for what I actually had. Good luck

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Prednisone makes all Pain better and is a happy pill to boot for me. I have RA and have only taken it a couple of times for a bad flare.
I was left wanting more - not because i still needed it for pain but because I liked the euphoria at the higher dose. Be careful.

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@cgm

I am down to 1 mg of prednisone after 3 years. I am also experiencing grip weakness and pain. My left hand is much more painful and my rheumatologist states it is osteoarthritis. However, it was one of my first acute symptoms before being diagnosed with PMR🤷🏼‍♀️I’ve tried every cream, massage, soaking my hands in ice water…the ice water worked best. Sorry…this isn’t fun.

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I was diagnosed with PMR over 6 years ago and have been on a constant treatment of prednisone during that time. My hands and wrists just started becoming very painful, especially in the earlier part of the day making it very difficult to do anything requiring strength of hands. I wonder if I've developed some RA along the way.

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I do not know that at this time. Not clear on RA symptoms. Do u have?

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@wilmingtonemperor

Off everything since mid February. 3 weeks ago woke up with a swollen right hand and wrist, my dominant hand. No better after using Tylenol and Volteran. I now have sausage fingers and can’t get a ring on. Right now at 707 AM can’t make a fist. I was first diagnosed in January 23 and have no desire to go back on prednisone.

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That's tough. I would probably do same but still have Somr Symptoms do on 3 mgs daily. Hands and wrists are sore and difficult to use

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In my 6th year of pmr. Been below 5 mg several times. A year ago both hands swelled, painful, could not make afist, kept dropping things. Crp elevated. The Rheum ordered xrays specifically looking for RA vs OA vs CPPD. I had hand xrays 4 yrs ago for comparison. Had some OA the first time, was.more advanced, and cppd arthropathy. Increased the prednisone dose, suggested methotrexate. Hands got better with the prednisone. Could not talk myself into taking mtx.
A year later now my right foot is the problem.. 3 months ago my foot swelled across the base of my toes, worse at the big toe where I had surgery 30 yrs ago. I opted for cortisone injection at the foot dr. It got better. Then got Achilles tendonitis, heel spur. Had rheum appt.
He ordered HLA-B27. Having this test done with monthly Crp, esr next week.
Starting PT today.
Since pmr started I have seen several specialists for various problems. May be coincidences, may be connected. Now looking for spondyloarthropathy.
Was at 4 mg. Told to take 5 mg am and 2.5 mg pm for a month. then 5 mg am til next appt in Aug. Heel is only somewhat better.
Suggested Kevzara which I said I would research. Copay will be expensive, getting approved will be a hassle.
In 6 years I have only found one person who has heard of pmr, it was her mother, and she said her mother had it for 20 years. Thought then I was doomed. It's a roller coaster. Started when I turned 70.

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@szf10

Hopefully the hand doctor you are going to see will schedule an EMG test to rule out carpel tunnel. After my PMR diagnosis and was put on Prednisone, I noticed my hands swelling while I slept and did not get better until hours after my morning dose of Prednisone,which I found odd but was happy for relief. But aside from seeing a rheumatologist, I went to a neurologist for second opinion and he sent me for the EMG. I needed to rule out carpel tunnel (which the test did) and be sure I was being treated for what I actually had. Good luck

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What other symptoms have you had? Do you have psoriasis? My daughter at age 34 was just diagnosed with psoriatic arthritis, she complained of sever swelling in her hands and fingers and also in her feet. She previously had psoriasis on her scalp.
Some people who have psoriasis develop psoriatic arthritis. She was diagnosed by a rheumatologist after an exam and blood work.

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I have had PMR for over 6 six and have been taking Prednisone all of that time. Only since last November did severe hand and wrist pain start for me. The Prednisone doesn't seem to touch that pain. My hands really are not swollen but painful to close hands or make a fist or grasp anything tightly. Could it be something else? Has anyone else experienced the same?

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@rosemargaret

I have had PMR for over 6 six and have been taking Prednisone all of that time. Only since last November did severe hand and wrist pain start for me. The Prednisone doesn't seem to touch that pain. My hands really are not swollen but painful to close hands or make a fist or grasp anything tightly. Could it be something else? Has anyone else experienced the same?

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It would certainly be something worth discussing with your doctor or rheumatologist if the prednisone isn't helping with the hand pain. Carpal tunnel syndrome and other symptoms could be involved.

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@pmrsuzie

In my 6th year of pmr. Been below 5 mg several times. A year ago both hands swelled, painful, could not make afist, kept dropping things. Crp elevated. The Rheum ordered xrays specifically looking for RA vs OA vs CPPD. I had hand xrays 4 yrs ago for comparison. Had some OA the first time, was.more advanced, and cppd arthropathy. Increased the prednisone dose, suggested methotrexate. Hands got better with the prednisone. Could not talk myself into taking mtx.
A year later now my right foot is the problem.. 3 months ago my foot swelled across the base of my toes, worse at the big toe where I had surgery 30 yrs ago. I opted for cortisone injection at the foot dr. It got better. Then got Achilles tendonitis, heel spur. Had rheum appt.
He ordered HLA-B27. Having this test done with monthly Crp, esr next week.
Starting PT today.
Since pmr started I have seen several specialists for various problems. May be coincidences, may be connected. Now looking for spondyloarthropathy.
Was at 4 mg. Told to take 5 mg am and 2.5 mg pm for a month. then 5 mg am til next appt in Aug. Heel is only somewhat better.
Suggested Kevzara which I said I would research. Copay will be expensive, getting approved will be a hassle.
In 6 years I have only found one person who has heard of pmr, it was her mother, and she said her mother had it for 20 years. Thought then I was doomed. It's a roller coaster. Started when I turned 70.

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I had pain in my hands and feet. I go to a fairly busy family Dr. They do lots of stuff besides. Like hormone therapy. My PA told me I was the only one in the practice diagnosed with PMR. I know why, they dont look for it. My PA had sent me to Mayo for diagnosis. Kevzara, Acterma are drugs that target the IL-6 receptor. More of a PMR inflammation marker. The thought is this drug will treat the inflammation from PMR so you can taper on the prednisone. But this drug does nothing to restart your cortisol. After 6 years your body is going to be shut down making cortisol and may not restart itself. When you hit the 5-7mg your body says thats it. It sends pain and inflammation which restarts your PMR. Maybe the Kevzara can hold it down but not if you dont produce cortisol to replace the prednisone. You may need to see a endocrinologist. That of course is just taking about prednisone and PMR. You may have other stuff going on.

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Thx for the info. It's complicated. I'm in 3 mgs and seems to be dealing w symptoms. Hands just do painful every morning tho. As I said never before? Only had issues w shoulders and hips in the past doc ruled out RA, thx god

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