Does PMR ever affect the hands?

so glad you said this Gillian, I was also having a lousy grip also dropping things and it was getting so annoying not knowif it was the PMR  

Ask the GP about the possibility of carpal tunnel syndrome - it is often found in patients with PMR and the tingling and numbness would fit.

Thank you Eileen, yes I had wondered about that myself.  Do yu know how or why PMR triggers it?

The Abstract from an article in Rheumatology (the journal for the field) says:

"Carpal tunnel syndrome and polymyalgia rheumatica have been seen together in 12 elderly patients. In five patients the symptoms of carpal tunnel syndrome preceded those of polymyalgia rheumatica. The most likely cause of the carpal tunnel syndrome is a local tenosynovitis, but oedema due to bilateral shoulder stiffness might play a part. In the three patients who underwent nerve conduction studies, the results confirmed the clinical diagnosis of carpal tunnel syndrome. The routine use of electrodiagnosis in polymyalgia rheumatica may show a much higher incidence of carpal tunnel syndrome than hitherto realized, or indicate that the association is purely fortuitous, both conditions being common in elderly women."

i.e. in plain English - the tenosynovitis that is so commonly part of PMR is probably part of it but the shoulder stiffness can also lead to oedema. Or it may be coincidence - but I don't think they really think that!

If it is any consolation to anyone - a Spanish study expressed the opinion that the hand/feet/carpal tunnel type symptoms are not found in someone with pure temporal arteritis (as they put it) so if your hands are bad - your eyes seem to be safer. Doesn't mean you won't develop the other versions of GCA affecting the rest of the body though.

 

Hi all I jumped right in on this discussion as since the beginning the hand issue has been the major issue with the doctors not wanting to say exactly what I have. When I said no to methotrexate the first rheumy advised I should get another doctor. I did and she also thinks I do not have PMR (because of the hand pain) totally ignored my feet pain. She ultrasound my hands and found no sign of RA except swollen tendons. She then gave me two hip shots a presription for naproxin and refused to give me a refill for prednisone. The pharmacy called and advised that when you have high blood pressure you cannot take naproxin so now I have to wait until Sept to see her. Thank goodness I have extra Prednisone and an appointment with GP for next Tuesday. I think Eileen you hit the nail PMR is the poor relation and here in Canada the prevelance is spread out over a large geographical area thats divided by province for almost everthing. Reading up on RA Lupus or MS would take priority over PMR. I believe I have PMR and until they can prove otherwise the treatment will not change as far as im concerned.

So a moderate dose of pred works and there is no evidence of RA? 

I really don't get why they will hand out naproxen and other NSAIDs like sweeties but won't use low dose pred - which used properly is what you are looking at and has no worse potential side effects. I was at a rheumatology meeting in Whistler in May - and we had a very lively discussion about the use of pred from PMR patients point of view. There were really good rheumies there who fully agreed with our view. Which I did find quite a relief! I wouldn't mind if the other drugs did something, anything to help. They don't. So please don't condemn me to a life of pain because YOU are scared of pred - I'm not and I do know what it can do. 

You are so correct and after 18 months and going from 20 to 2.5 im done with the pain hence the appointment with GP. I will be telling him that I Have on my own experimented with larger doses for 5 days at a time and the prednisone gets rid of the pain. HANDS AND FEET INCLUDED. l will follow up next week to let everyone know how it went Joanne

All the information I gather here makes me thankful that I only deal with my GP.  On the other hand I was undiagnosed for over a year by a previous GP, who in her defence was quite young and may never have encountered PMR before.  I also suspect that towards the end of my time with her she had "baby brain" as she was pregnant.  

I worry the same way. I would much rather it be PMR not RA. They do say that RA is not hereditary but in my family my grandmother had Padgets disease and currently my Mom sister and my neice have thyroid disease so I do beleive we all carry some of the same genes that predispose us to autoimune diseases.

Hi,my PMR has morphed into late onset RA plus PMR.My mam and her mam both had RA and everyone was hoping it would miss me out (it has not yet they still insist it is not hereditary)

Hi Gillian without being too nosey what was the deciding factor or factors that made the diagnosis for RA Joanne

About 1 in 6 people who get a diagnosis of PMR to start with have it revised at some later point - mostly to LORA (late onset RA). Usually it is the fact patients aren't responding well to pred, can't reduce the dose - or, the really clinching factor is finding erosions in the joints on x-rays. The hand pain in PMR is less IN the joints as down the sides of fingers and can spread up the tendons in the forearm. 

It isn't hereditary as such - but all autoimmune disorders have a certain degree of a genetic component. If others in the family have one - you are more likely to develop one than someone in a family with no history of such illnesses. Needn't be the same one - but it IS in the genes. That just means that you are more likely to get it when exposed to certain (unknown) environmental factors than someone who doesn't have the gene. But then - you are likley to experience similar things to the family.

"Researchers have established that certain genetic markers may increase your risk of developing RA. The genes in question are related to the immune system in general, to chronic inflammation, or with RA in particular. It is important to note that not everyone with these markers develops RA"

Feeling all my joints and doing a pain score assessment plus the rheumatologist did not dismiss my family history-maybe she is a more enlightened one ☺

In my case I already had asthma,hayfever,and various allergies so basically my immune system is away with the fairies☺