Wrist and finger pain while tapering prednisone

Posted by terrym @terrym, Oct 23 1:54pm

I know there are similar threads within other discussions, but wanted to start a fresh, focused discussion.

I've been tapering from 20 mg of prednisone since mid August and am down to 13mg as of today. I had a couple of "mini" flares, but jumped back to previous dose for 2-3 days and resumed taper for the next two weeks successfully. At the 20mg I was pain free and with the tapering, had very mild pain (1-2/10) and stiffness in the mornings for the first couple of days that was pretty much gone by the next taper down. However, at my last taper from 15 to 14mg, my wrists and some fingers were at a 3+/10 level and very stiff in the morning. By late afternoon it is down to a 1+/10 level. The wrists almost feel like they are sprained and the lower palms like they are bruised. The annoying part of this is opening containers, manipulating small items, playing golf in the morning on weekends, etc. I chalk up the finger pain to normal arthritis wear and tear.

To keep the tapers going, I'm willing to put up with wrist pain at the current level as long as my other joints remain at the low levels. Everything else is going well so far, inflammation markers are back in normal range, just had a bone density scan that looks good and above normal and most prednisone "issues" are much better.

I do a split dose and have been holding the morning to 10 mg and tapering the evening dose. Maybe I should keep the doses equal?

Has anyone else had this issue and if so, have you found any solution for relief?

Thanks, Terry

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

Tapering seems to be progressing fairly well. I have been on since April, starting at 15mg and right now down to 2 1/2mg. As you mentioned I have some discomfort with my right wrist/fingers only. I’m in physical therapy at present to attempt to revive my loss of muscle so will point that out to the therapist tomorrow.
I’m looking forward to being off prednisone totally – don’t like steroids and they don’t like me but worked for PMR unfortunately with every side effect.
I am gluten free for approximately 12 years so my guess that starting the medication was significantly lower dosage than others since my inflammation levels are most likely lower than those on normal diets. So again I’m just guessing my lowering at this point is allowing inflammation to build back to the normal level I was at prior to taking this medication and this may become what I need to deal with when off prednisone. Only time will tell and my rheumatologist can hopefully clarify.

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My experience is similar to yours. I have had a hard time reducing my dose and had to resort to reducing ¼ ml at a time but it seems to have worked. After I reduced it to 1 ¼ ml my wrists and fingers were painful and had no strength in them. At first I attributed it to advancing old age (79) but as it wasn’t constant It didn’t seem likely. It's wearing off now so I am hoping that that will be the end of it.

It’s been over 4 years since PMR diagnosis and I am pretty much over it and working to cut out prednisone entirely. I use Arnica gel for pain relief which works well for me, and stretchy arthritis support gloves to rest the joint when I’m working. One thing I am having to work through is the need to separate the effects of advancing old age from PMR, and it hasn’t been easy. Also I haven't been as strict with food as I was and find myself slipping into a few bad food choices. Halloween candy is a trial I have not been able to resist. Still that light at the end of the tunnel is almost here and I am so grateful for that.

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Too new to PMR to offer much help. Tapering prednisone from 25 mgs down to 18 by next week. My doc is dropping me by 2 mgs every two weeks until I reach 10, then one mg per month. A pretty long haul, but so far so good. I have high hopes for no relapse. This site has been extremely helpful, especially the suggestion I got here about splitting doses morning and night, which was a life-changer for me! Thanks all and Mayo!

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Hi Terry; I feel your pain. Could not even press the button on my can of shaving cream while having the flare. I had to go back on prednisone after 5 weeks off entirely. Now at 15mg and will go to 10 next week. Had my first injection of Kevzara this morning and hopefully as the Kevzara starts taking hold I will be able to quit prednisone entirely. Try Volteren for your hands and wrists, it gave me relief.
Good luck; John

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I’ve been dealing with palm and finger pain along with neck pain while at 5mg of prednisone. It’s difficult to use my hands for most everything. I use a rollator walker and just holding the handlebars is painful. The level of discomfort is gradually decreasing and improves after the prednisone gets in my system. I have a phone appointment with my rheumatologist in two weeks. Not sure if he will resume my taper which has been on hold for two months, increase my dosage or have me stay on the current dosage. I’m doing inflammatory markers tomorrow. And the band plays on!

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"I do a split dose and have been holding the morning to 10 mg and tapering the evening dose. Maybe I should keep the doses equal?"— @terrym – I have been keeping the two doses equal – but at request of my Rheumatologist I did move the evening dos closer to dinnertime and not bedtime – I think it definitely improved my sleeping. I was Dx in April 2023 , had to be bumped up to 30 mg Prednisone , tapering 2.5mg/month till reaching 10 mg , and now am ready to begin 7 mg. Your comment about wrist / finger caught my eye as I was just dealing with "tingling" down both arms to the wrists – I have a history of stenosis in the cervical spine and a visit to the osteopath and review of my old PT exercises for my neck have rid me of the tingling entirely! in my searching I have found many a reference for DISTAL muskoskeletal manifestations in PMR patients, including carpal tunnel syndrome , and peripheral arthritis ….. (My husband , coincidently just had carpal tunnel surgery – since you re not mentioning numbness I feel you have ruled that out already ? ) I,m not sure how all Rheumatologists /PCPs respond to being plied with literature searches but I will attach the two references for you below

Shared files

2001 Narvaez Muskulosketal manifestations (2001-Narvaez-Muskulosketal-manifestations-.pdf)

2006 Peripheral Musculoskeletal Manifestations in Polymyalgia Rheumatica (2006-Peripheral-Musculoskeletal-Manifestations-in-Polymyalgia-Rheumatica.pdf)

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@wilmingtonemperor

Hi Terry; I feel your pain. Could not even press the button on my can of shaving cream while having the flare. I had to go back on prednisone after 5 weeks off entirely. Now at 15mg and will go to 10 next week. Had my first injection of Kevzara this morning and hopefully as the Kevzara starts taking hold I will be able to quit prednisone entirely. Try Volteren for your hands and wrists, it gave me relief.
Good luck; John

Jump to this post

I'd love to hear updates on the Kezara ! I know there are several other threads about taking biologicals . I have one question for you if you don't mind – is your insurance covering the cost ? I am trying to decide if I should change my Medicare Part D to cover higher tier drug for next year ! : )

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I too have had trouble distinguishing between pmr symptoms and ordinary aches and pains. Long-standing hip pain in the groin (as opposed to outer hip) which I thought was due to pmr was pretty well dealt with using PT. Same with left shoulder issues. I am convinced that my right-hand pain and numbness are due to carpal tunnel issues brought on by heavy work.
I am 73 y.o., pmr since 11/2022, now at 6 mg Prednisone.
Regarding kevzara, at the suggestion of my rheuma I applied for and have received free access to the drug directly from the company. This was possibly due to my having consented months ago to being "studied." All this amounts to is that every time blood is drawn they take seven vials instead of one.
I am not entirely sure I want to take kevzara as it has its own long and forbidding list of side effects. Need to discuss further with rheuma.

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@broncosport1

Tapering seems to be progressing fairly well. I have been on since April, starting at 15mg and right now down to 2 1/2mg. As you mentioned I have some discomfort with my right wrist/fingers only. I’m in physical therapy at present to attempt to revive my loss of muscle so will point that out to the therapist tomorrow.
I’m looking forward to being off prednisone totally – don’t like steroids and they don’t like me but worked for PMR unfortunately with every side effect.
I am gluten free for approximately 12 years so my guess that starting the medication was significantly lower dosage than others since my inflammation levels are most likely lower than those on normal diets. So again I’m just guessing my lowering at this point is allowing inflammation to build back to the normal level I was at prior to taking this medication and this may become what I need to deal with when off prednisone. Only time will tell and my rheumatologist can hopefully clarify.

Jump to this post

Greetings and thank all who contribute.
Most of you, like I've said before have written my journey. Going down from 20mg in the last several weeks , currently starting 14mgs. Not to much to complain about in the pain department. But the navigation of blood pressure ups and down is concerning, am 140ish over 87ish but evenings are 97/67 pretty common. Which is when my battery runs on the side of low, and can actually feel it coming on.
Been trying to do the balancing act with the BP meds. Currently on mid range dose there.
Sleep is ranging from 4 to 6 hours which replaced 8 or 9 at the darkest side of this affection, before Prednisone.
Yep same stores just change the names pretty much from what I ascertain.
Thank you for your posting, and if you get this stuff figured out to near 99% please let me know.
As I begun to wonder if I will see a referred rheumatologist in my life time. So frustrating just would like to be reassured what I have and what I need to do moving forward.

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@nyxygirl

I'd love to hear updates on the Kezara ! I know there are several other threads about taking biologicals . I have one question for you if you don't mind – is your insurance covering the cost ? I am trying to decide if I should change my Medicare Part D to cover higher tier drug for next year ! : )

Jump to this post

Hi; yes my insurance is covering the Kevzara. However, I am retired military and I have TriCare for Life after Medicare. TriCare's pharmacy program is Medicare Part D for military retirees. I am absolutely blessed to have the pharmacy coverage that I have. I have read that out of pocket for Kevzara is about 5K without insurance. Personally I think, as Kevzara is recognized as an alternative to prednisone, insurance companies will be required to cover it.
Good Luck

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