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Does it matter when Carpal Tunnel Syndrome symptoms reappear upon tapering?

Posted , 11 users are following.

carldk
carldk

About 3-4 weeks after my PMR symptoms started I developed CTS symptoms in my right hand and arm. This was before I started taking prednisolone. I am now down from 20 mg to 10 mg a day. My general PMR symptoms are totally suppressed, but my CTS symptoms are not, and they seem to become gradually worse as I am tapering. At my last reduction from 12.5 to 10 mg, EST, CRP and Fibrinogen were all normal. But the CTS symptoms with tingling and numbness in my hand is now getting pretty bothersome.

I know that CTS often accompanies PMR, but it is not clear to me if the CTS symptoms should be considered part of the PMR symptoms that the body will fight off as it deals with the PMR. Or whether the CTS is a separate disease triggered by the PMR. If it is the latter it may be that the body will not get rid of it on its own, or that the body may fight it on a different schedule as compared to the "general PMR".

So, is it worthwhile to try and increase the pred dosis to get rid of the CTS symptoms? Will it even work? It has often been stated in this forum that pred does not help the body to fight the PMR. It is merely a pain killer. If that is the case then I would rather endure the discomfort of the CTS symptoms than I would increase the pred dosis due to all the bad side effects of this drug. I do, however, read elsewhere that taking pred reduces the risk of developing GCA, and I also read that CTS needs to be treated to avoid long-term problems.

So, what is the best thing to do? If anyone can shed light on this problem I would be grateful.

 

0 likes, 11 replies

11 Replies

  • carldk
    carldk

    Posted

    Typo: EST should be ESR, of course.
  • Silver49
    Silver49 carldk

    Posted

    I don't know the answer to your question  but prior to PMR being diagnosed I had a Morton's Neuroma which eased completely when I started Pred. As I was reducing it returned though not as painful. I continued to reduce and it eventually cleared up completely. I have also had sciatica which I had never had prior to PMR and it came and went a few times. I am now on 2.5mgs and so far so good but I have something else which was possibly a precursor to PMR. I am cautiously optimistic that this not a flare and have put it down to a recent stressful period. I'm sure someone more knowledgeable will be along soon to advise. 

  • mary19068
    mary19068 carldk

    Posted

    Hi carldk

    I would suggest you ask your doctor to refer you to a hand consultant at your orthopaedic clinic and have the trapped nerve released....

  • Anniecurd
    Anniecurd carldk

    Posted

    Hello Carldk,

    I had very painful CTS for a couple of months before I started on pred, but the pain and numbness was completely relieved by the pred. In July of last year, I was able to go off the pred, and everything was fine until I started back doing my home improvements. I put a new floor in my kitchen in January, and have had wrist pain since then. So it looks like in my case, although my PMR has resolved, the CTS has not. So I would not automatically assume that the CTS is from PMR.

    Ann

  • EileenH
    EileenH carldk

    Posted

    I think the CTS is generally part of the PMR - i.e. if you didn't have PMR you probably wouldn't have CTS, if you see what I mean. However, if you need above 10mg of pred to manage the CTS symptoms but not any other PMR symptoms - you possibly need to speak to a specialist. Have you tried using wrist splints? That often helps relieve the discomfort and pain.

    • carldk
      carldk EileenH

      Posted

      Thank you, Eileen. I feel the same way. I am using a wrist splint at night and it helps. If I ignore the CTS symptoms, live with the discomfort, and continue tapering, focusing on controlling the other PMR symptoms, what do you think will happen with the CTS? Will it go away eventually?

      Anybody out there with a similar experience?

       

    • EileenH
      EileenH carldk

      Posted

      I honestly have no idea! I suspect maybe not.
    • Harrie4
      Harrie4 carldk

      Posted

      Hi Carl 

      I’ve had PMR for almost 3 years now at one point getting off Pred completely then flared 9 months ago so I’m on 9mg right now. As it happens, I’m going for the Carpal Release procedure tomorrow. I would suggest that you have the nerve conduction test in both arms to get an empirical read on the issue. Even though at 15%, there’s reason to consider the correlation between PMR and CTS, when I upped my prednisone as an experiment it made no difference. So I’m treating these issues as distinct and going for mechanical intervention to widen the tunnel so I can get full enervation again.

      Hope this helps!

  • Danrower
    Danrower carldk

    Posted

    I had "trigger finger" when at the height of PMR and RS3PE symptoms. The way I figure, of swelling and inflammation are in the mix, then  the little portals which house the tendons may also constrict. That's how I figured it. My 2 cents worth. Good luck.

    Dan

  • peggy_56092
    peggy_56092 carldk

    Posted

    I have had bouts of CTS: 1) in an office job ten years before PMR; 2)  years later gardening during my second or first year of PMR on pred; 3} waking up today with a useless swollen thumb joint, again from gardening, which is gradually beginning to subside. My body is stressed from an ulcer issue involving many  meds in addition to my 7 mgs pred.  The CTS seems to heal with rest for my previous and today's event. 

    cts

  • margaret22251
    margaret22251 carldk

    Posted

    Hi carldk. I have CTS and wear splints at night. Had a scan and the doctor was great to me, it took about a month before I saw an improvement but unless I overdo it, like gardening, doing heavy lifting etc I can have a off day,  maybe you could mention it to your doctor you never know.

    hope this may help a little.

    regards madmags 

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