Bad case of swollen fingers and carpal tunnell.

Posted , 8 users are following.

A while ago I posted about a big problem I suddenly developed when my hands and fingers became very swollen,painful, and numb in my thumb and first and second finger.  I also had pains in my wrist and going up as far as my elbow.  I could hardly lift a cup of tea and certainly not a whole kettle...driving was impossible, opening packets and jars had to be done by someone else.  I put myself up from 7.5 of my Pred dose to 10, but it had had no effect.  eventually my sensible GP increased that to 15 saying it would at least rule out other causes if it was a flare from the PMR and sure enough after ten days the swelling has almost completely gone and I have about 80% of my hand strength back and am attempting to drive again.

I'd noticed that a couple of other people on the forum had had similar problems so I just thought it would be useful to share this, as I was panicking about Late Onset RA, or a sudden devastating attack of Carpal Tunnell.   At least they seem to have been ruled out.

I'm not sure how I feel about having gone back up to 15 of the Pred though and worried that it will recurr when I drop down again.  Dr wants me to stay on 15 for 6 weeks and then drop to 12.5, so that's what I will do although maybe in smaller steps. Also I 'm booked for a test for CTS at the hospital, which he says I should still go for, as there may be an underlying cause.  It seems quite a few of us end up with CTS as well.  Ah well...

1 like, 18 replies

18 Replies

  • Posted

    I will be very interested to see what everybody says because I suffer mostly in my right hand but some in my left hand too. I had the nerve conduction study done and it came back with borderline carpal tunnel syndrome. I told my doctor that I am under enough pain with my lower back and PMR that I don't care if it's borderline I want to do something about it so he has referred me to an ortho surgeon. Then I saw a TMJ specialist for my TMJ that has come up too. My TMJ specialist said it could have been caused by the TMJ. I thought that was interesting. So I've waited the three weeks he thought it would take wearing the Moy guard to see if that worked and it has not. So it's off to the ortho I go. But I will say one thing that has helped me tremendously that you might try is I bought a thumb guard at the suggestion of my rheumatologist. It kind of looks like a wrist guard because it does wrap once around your wrist but it has a place to put your thumb and your fingers are loose. As long as my thumb is protected like this the rest of my wrist and arm is perfectly comfortable. I bought it at a drugstore. I don't know if you're in the US but if you are I bought it at CVS for $15 or thereabouts. I've even tested Myself by not wearing it and it took approximately 30 minutes before the pain came back.

    • Posted

      Thank you for your comments amkoffee. I didn't know what TMJ was, but I just looked it up and it sounds very uncomfortable. I'm in the UK, and I haven't tried using any sort of wrist or thumb guard. I do have to lock and unlock various doors, attach the dog's lead, take pills out of packets, and do other tasks every day with my hands so I 'm not sure if I would be able to wear one...just at night maybe.

      I got a nasty shock today however - I was 4 hours late taking my Pred today and the pain and burning in my hand came back when I tried to drive so I'm not clear of it yet even though it has been so much better since I went back on the higher dose.

      My Dr says the pred stays in youir system so it doesn't matter if you take 15 one day and 10 the next when you are cutting down but it seems to me that we are more responsive than that to the amount we take  and the time we take it.

    • Posted

      Ask your doctor if HE has ever reduced pred in PMR himself? After being on it for more than a couple of weeks? 

      It DOESN'T "stay in the system" - most of the pred dose itself is gone in 12 hours as prednislone has a half life in the blood of 2 to 4 hours. So if you are a "2 hours person" in 2 hours half of it is gone, in 4hrs 75% has gone, 6 hours nearly 90% and so on.

      What DOES last longer is the antiinflammatory effect - and that also varies: anything between 12 and 36 hours depending on the person. And a "12 hour" person will often find symptoms returning by late evening. "On average" it is 24 hours - but the human individual is not "average".

      It doesn't work well for most people to alternate 15 and 10 - I don't care what he says.

      The supports are velcro fastened - easy enough to put on and take off.

  • Posted

    Carpel tunnel syndrome can often be part of the PMR scene - but just because the 15mg pred relieved it isn't saying it was ONLY PMR. Carpal tunnel syndrome is caused by swelling that pinches the nerve passing through the space - and the pred relieves it when it is high enough. Corticosteroid injections are often used - which means a far lower overall total pred dose. Not sure you need 15mg for 6 weeks though before tapering - given the nature of PMR that is, you only need enough to deal with each new daily dose of inflammatory substances so once the current symptoms have gone you could try a small reduction.

    I had wrist and hand problems with PMR and a wrist support made a big difference to comfort.

    • Posted

      I tried to wear the wrist support too but it seemed the more I wore it the more my thumb would ache. That is what prompted me to go back to my rheumy's suggestion of the thumb support. Then I read that the thumb hurting is a sign of CT also so I wasn't suprised any longer.

    • Posted

      Thank you Eileen. I think you are right, and would prefer to stay at 15 for a month and then drop more slowly this time.  My doctor says that surgery is the better option as the injections don't last long . I don't fancy either, but I will have to wait to see what the consultant says. I just hope they will have experience of PMR and how it interacts with CTS.

  • Posted

    Just posted note to you. Flares have been when I try to go below 9.5 mg. Think I need to stay there for 6 months or longer.
    • Posted

      I was at 7.5 when this happened, and I think I had gone down too fast, but I'm sure it was the blood pressure meds that started it. 

    • Posted

      Not necessarily 6 months - often even 1 month is the difference between failure and success.
  • Posted

    My right hand and around three fingers are numb each morning normally that it improves after a hour or so after I am up. Split my dose to 10 mg prednisone at night 7.5 in morning, helping some. I am sure I have CT from years as a electrician. The PMR has magnified my CT and brought pain in right elbow from a old injury.
    • Posted

      I've always overused my hands...I make glass beads and throw pots on the wheel...at least I did before all this happened.  I think PMR seems to attack our weakest points.

  • Posted

    I was a bit luckier. Had to increase from 3.5 to 5 and do fewer things. Back to 4.5mg /day now, nudging 4, after about 5 months. My hands are a little swollen, particularly right which I use most. Fingers a bit stiff between the joints. The background diffuse "brown" pain between joints is much less. Hardly noticeable. Wrists now ok. At its worst my wrists had sharp pain across the joint and fingers sharp pain with little strength. I was pleasantly surprised kayaking was ok recently as I expected the extra strain on hands and wrists to have an adverse effect, but no.

  • Posted

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    }I have had carpal tunnel in my right hand (and now, to a lesser extent, in the left) since the onset of PMR.  It has steadily improved but is still present.  Right now I am on 10 mg. of prednisone and about to decrease.  For a couple of months I, too, could hardly lift anything, had trouble driving, and couldn't open things.  Now I can just manage with difficulty.  Hoping it continues to improve even on lower dosages of prednisone, but thanks for sharing your experience with us so I can be forewarned in case it gets worse.  Good luck!  Interested to find out what the results of your CTS test will be.

    • Posted

      Hi Dane, yes,I had it today and it will take a couple of weeks for the results to go to my Dr. It will be interesting to see what they say.

      I would say decrease aby a very small amount to start with...that's what I intend to do.  10 % of the dose you are on now seems to be the safest from what I have gathered here on this forum.

    • Posted

      The 10% rule is the maximum. At 15mg for example, 10% is 1.5mg but 1mg is often enough for many people. It may SOUND slow, but it isn't slow if it works!

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