PMR with hand/wrist pain and swollen veins?

Posted by ldingwall88 @ldingwall88, Aug 23 1:22pm

Hi, I've been struggling with PMR since May '22. Most of my symptoms are typical though apparently unusually stubborn; I'm currently on 40mg/day prednisone and hoping to begin a taper soon. (I started out at 20mg but nothing touched the flare til they bumped me up to 40) One uncommon symptom is severe pain in my wrist/hand, and when it's particularly bad the veins in my hand, wrist, and lower arm get very large. Has anyone else experienced this? It's kind of freaking me out.

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

Hi @ldingwall88, I have had pain in my hands and wrist when my PMR was active but didn't seem to have much swelling. Here's some information I found on the topic.

"Arthritis very often affects hands and wrists. Vasculitis has also been considered as a possible disease mechanism of PMR and PET has revealed…"
— Polymyalgia rheumatica is associated with extensor tendon tenosynovitis but not with synovitis of the hands: a magnetic resonance imaging study: https://academic.oup.com/rheumatology/article/50/3/494/1791082

"Occasional swelling or stiffness of the small joints of the hands. Swelling in the wrist can lead to numbness, tingling, and pain in the hands ( …"
— Patient education: Polymyalgia rheumatica and giant cell arteritis (Beyond the Basics):
https://www.uptodate.com/contents/polymyalgia-rheumatica-and-giant-cell-arteritis-beyond-the-basics/print

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My veins in my hands are very small in the morning. They get significantly larger as the day goes on. It is because of the large amount of liquids that I drink. I have been purposely drinking more since I have been on prednisone.

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@loyal

My veins in my hands are very small in the morning. They get significantly larger as the day goes on. It is because of the large amount of liquids that I drink. I have been purposely drinking more since I have been on prednisone.

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Now that you mention it, my hands/veins are the same, and I've been drinking a lot of liquids too to flush my system as much as possible. Thanks!

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I am so glad I found your question. I have been struggling with pain since this past Jan 22, with right shoulder pain, then thumb arthritis and then a swollen tennis elbow. After a couple trips to the orthopedics with prednisone shots, and physical therapy, my next culprit was carpel tunnel in my other wrist, along with my left shoulder pain. My blood work brought me to a rheumatologist and here I am with a working diagnosis of PMR. I am only 55. Just started 20 mg of prednisone. Over the past month, I did notice the veins in the back of my hands look strangely large, even in my forearm. Since I am googling everything PMR, this is one that I cannot seem to find a correlation with. I did read up on the covid vaccine booster as suspect to PMR outbreak. I had mine late December 21, and all this started happening. Sorry I could not be more informative. May helps to identify, that yes, I am this problem currently too!

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@dawne

I am so glad I found your question. I have been struggling with pain since this past Jan 22, with right shoulder pain, then thumb arthritis and then a swollen tennis elbow. After a couple trips to the orthopedics with prednisone shots, and physical therapy, my next culprit was carpel tunnel in my other wrist, along with my left shoulder pain. My blood work brought me to a rheumatologist and here I am with a working diagnosis of PMR. I am only 55. Just started 20 mg of prednisone. Over the past month, I did notice the veins in the back of my hands look strangely large, even in my forearm. Since I am googling everything PMR, this is one that I cannot seem to find a correlation with. I did read up on the covid vaccine booster as suspect to PMR outbreak. I had mine late December 21, and all this started happening. Sorry I could not be more informative. May helps to identify, that yes, I am this problem currently too!

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Hello @dawne, Welcome to Connect. Sorry to hear you have joined the PMR club. I've had two occurrences of PMR. The first happened when I was 64. My PMR is currently in remission. You are not alone with your struggle. Many of us have shared what has helped us in the various discussions on PMR. You can find a list of the discussions here:

— Polymyalgia Rheumatica (PMR):
https://connect.mayoclinic.org/group/polymyalgia-rheumatica-pmr/
As you start tapering down on the prednisone, you might also find the following discussions helpful:
— Prednisone tapering is challenging. What does remission feel like?:
https://connect.mayoclinic.org/discussion/prednisone-tapering-and-remission/
— PMR Dosages and Managing Symptoms:
https://connect.mayoclinic.org/discussion/pmr-dosages/
Has your rheumatologist suggested any tapering plans or lifestyle changes to help manage the symptoms?

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@dawne

I am so glad I found your question. I have been struggling with pain since this past Jan 22, with right shoulder pain, then thumb arthritis and then a swollen tennis elbow. After a couple trips to the orthopedics with prednisone shots, and physical therapy, my next culprit was carpel tunnel in my other wrist, along with my left shoulder pain. My blood work brought me to a rheumatologist and here I am with a working diagnosis of PMR. I am only 55. Just started 20 mg of prednisone. Over the past month, I did notice the veins in the back of my hands look strangely large, even in my forearm. Since I am googling everything PMR, this is one that I cannot seem to find a correlation with. I did read up on the covid vaccine booster as suspect to PMR outbreak. I had mine late December 21, and all this started happening. Sorry I could not be more informative. May helps to identify, that yes, I am this problem currently too!

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Your post is validating to me, as my rheumatologist says the hand involvement is not PMR. My veins are more prominent as well, maybe due to thinner skin from prednisone? So many questions! Best of luck to you!

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@dawne

I am so glad I found your question. I have been struggling with pain since this past Jan 22, with right shoulder pain, then thumb arthritis and then a swollen tennis elbow. After a couple trips to the orthopedics with prednisone shots, and physical therapy, my next culprit was carpel tunnel in my other wrist, along with my left shoulder pain. My blood work brought me to a rheumatologist and here I am with a working diagnosis of PMR. I am only 55. Just started 20 mg of prednisone. Over the past month, I did notice the veins in the back of my hands look strangely large, even in my forearm. Since I am googling everything PMR, this is one that I cannot seem to find a correlation with. I did read up on the covid vaccine booster as suspect to PMR outbreak. I had mine late December 21, and all this started happening. Sorry I could not be more informative. May helps to identify, that yes, I am this problem currently too!

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At first I was told my hands and left wrist were separate issues but over the past 2 years they are involved in every flare when I start my taper off Prednisone. I believe that the doctors and our selves are going to keep learning about this and are finding that each case may be different yet similar. Keeping a pain journal specific to area the pain is in is very helpful

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I certainly have quite bad wrist and hand pain in my right wrist …along with numbness and tingling but no swelling of veins. An ice pack does help.

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@sharonanng

Your post is validating to me, as my rheumatologist says the hand involvement is not PMR. My veins are more prominent as well, maybe due to thinner skin from prednisone? So many questions! Best of luck to you!

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Would question why your rheumatologist seems to think the hands are not part of PMR. This disease affects everyone differently. Some have elevated blood work, while others do not. The one main stay is pain. It is well known that PMR causes the white blood cells to attack the linings of the muscles and tendons, which ultimately causes inflammation. There is no question that there are muscles and tendons in your hands.
Every morning I wake, I have pain from the shoulders to the wrist and hands. Prednisone takes the pain away.
Good luck in your journey. Wish you only the best.

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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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