Swollen hands, rash with PMR

Posted by razhuny @razhuny, Oct 12, 2022

Anyone else get debilitating swelling in their hands with onset of PMR? Also broke out in rash on my elbows & hands. Two days after going on 15mg Prednisone the swelling went down. Now the skin is in rash areas is peeling.

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My hands have been involved since day one of my diagnosis. My rheumatologist says not PMR. Primary says is PMR. As I tapered prednisone, the hands got worse with swelling and pain. Rheumatologist says inflammatory arthritis or rheumatoid arthritis and put me on hydroxychloroquine. I've been on it for 15 days; no results yet. Hands hard to use in the morning, get better as prednisone kicks in, but pain never goes away completely. I am encouraged by others who have stated hand issues go away when PMR is resolved.

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Welcome @razhuny, I see that @sharonanng has connected with you and shared her experience. I just thought I would also jump in and share that when my PMR was active, my wrists and hands were stiff and painful also. I don't remember noticeable swelling but I'm sure there was some. 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 (called carpal tunnel syndrome) is listed as one of the most common symptoms of PMR.

-- 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

It's good to hear the pain went away after starting on the prednisone but I'm surprised it took 2 days. My pain went away within hours of starting my prednisone starting dose of 20 mgs for both occurrences of PMR.
Did you start at 15 mg prednisone after being diagnosed with PMR?

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Yes, my Rheumatologist prescribed 10mg am, 5 mg at 5:30pm. He said my PMR is severe. I had to use wheelchair to get to appointment. Could do no weight bearing on hands, wrists, shoulders or knees.
Wondering if there is another diagnosis?

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@razhuny

Yes, my Rheumatologist prescribed 10mg am, 5 mg at 5:30pm. He said my PMR is severe. I had to use wheelchair to get to appointment. Could do no weight bearing on hands, wrists, shoulders or knees.
Wondering if there is another diagnosis?

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I'm not a doctor but the starting dose might be too low if it didn't relieve the pain. Here's some information on starting doses and it might be worth discussing your pain level with your rheumatologist on the current dosages.

-- The Correct Prednisone Starting Dose in Polymyalgia Rheumatica is Related to Body Weight But Not to Disease Severity: https://www.medscape.com/viewarticle/747264_2

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@johnbishop

I'm not a doctor but the starting dose might be too low if it didn't relieve the pain. Here's some information on starting doses and it might be worth discussing your pain level with your rheumatologist on the current dosages.

-- The Correct Prednisone Starting Dose in Polymyalgia Rheumatica is Related to Body Weight But Not to Disease Severity: https://www.medscape.com/viewarticle/747264_2

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My pain is controlled at 15mg daily. My original question was if my extremely swollen arms & hands with rash on hands & elbows is a common symptom for onset of PMR?

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@razhuny

My pain is controlled at 15mg daily. My original question was if my extremely swollen arms & hands with rash on hands & elbows is a common symptom for onset of PMR?

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I didn't have any rash with either occurrence of PMR that I had but did have some hand pain with very little swelling. Maybe other members can share their experience with the hands and PMR.

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With PMR, I have painful, swollen wrists and stiff hands. And, a rash on the inside of my foot that peels.

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My last two attempts at tapering when below 5 mg ignited a swollen painful hands response. I went back up to 10 mg, probably tapered too quickly down to 5mg but I followed the Dr's tapering schedule. I know I have arthritic joint issues in my fingers/hands/wrists from xrays. It's not going to disappear. I think I read somewhere that most of the elderly population will develop some degree of hand arthritis. I started out with classic pmr hip and shoulder pain. I needed a cane to get out of bed in the morning. I'm like in a different ball park now. I have had a lot of bloodwork done the last few years. I am 'tuned in' to the numbers because I used to work in a hospital chemistry lab. My crp and wbc count, neutrophils elevate when I have a flare. They sent me to a hematologist once. At this point I'm not sure any medicine can magically fix my whacky immune system that periodically goes into overdrive. I think my Dr. made a comment once that "maybe you're just one of those people that will need a low dose forever" or something to that effect.
I am at 7 mg and feeling pretty good in the morning. I have occasional pain in my hands throughout the day and I take Tylenol sparingly. The pain is where the xrays have shown arthritic changes. I'm using ice packs or heat at times. I'm attempting to taper .5 mg every two weeks by alternating the .5 reductions for a few days to get to the lower dpse.
I've never had a rash from pmr or as a response to prednisone. Sounds like an additional symptom related to an immune response caused by an additional immune problem.
suzanne

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