PMR and RA treatment question
Posted , 9 users are following.
I have PMR since November 2015 and was slowly reducing and got to 3mg, when I started having problems with knuckle joints, pain, weakness and swelling. About 3 weeks ago I saw Rheumi and he suggested not to reduce pred any more and also gave me some ointment for inflammation/pain. It helped a little, but did not really improve the swelling /pain much. I requested another appointment and saw him again a week ago. He thinks it is most likely RA, and that swelling is because of synovitis. He increased the dose of pred from 3mg to 8mg and I will see him again in 3 weeks .
Inflammation and pain was gone pretty much after 2 days. I have actually increased the dose to 9mg (6mg after midnight and 3mg in the morning) for 6 days now. All the symptoms of RA are gone..
Now question: I would like to go back to lower dose (4-6) ASAP before my adrenals shot down again, but don't know what sort of treatment RA requires as far as dose and time. Is this going to be weeks, months or longer? Does RA stays under control on lower dose of pred?
Just for a reference, if I recall correctly, i did not have any hand problem above 4mg, and I noticed them first when I reduced from 3.5 to 3mg
0 likes, 22 replies
nick67069
Posted
EileenH nick67069
Posted
nick67069 EileenH
Posted
From your experience, how long does it usually take for synovitis to be healed?
EileenH nick67069
Posted
With enough pred my hand synovitis took a few months to fade - but that was at the start when they must have been pretty inflamed after 5 years! If it is all your knuckles injections might be a pest.
However - is it JUST synovitis? Have you been doing anything with your hands to cause it? Or is it early RA? Have you had any imaging?
You might like this: https://rockandice.com/climbing-injury-prevention/fingers-arthritis/
nick67069 EileenH
Posted
Thanks for you answer Eileen. I am not sure any more if it is "just synovitis". Before it happened, back in May this year, I have changed to new bike, which had different geometry and different stress on my hands. Although I noticed that my hands hurt while I ride, I assumed it will go away. Late May I went for 3 week trip to EU, and that is when my hands (knuckles) became inflamed. Because of the timing I ruled out bike riding as a cause. In retrospect, it might have been delayed reaction, who knows.
After returning to Japan I have seen rheumi. He did ultrasound and made a comment about synovitis or early RA and gave me some topical oiment to use, which did not work. I saw him second time after a week and then he prescribed higher dose of pred, which worked. Third time when I have seen him ( early July) he was sure it was not RA, just synovitis. Since then I was able to reduce pred from 9mg to 4-5mg before symptoms started to return. The pain compared to PMR is more like annoyance, much lower intensity. Throughout this time I have been using my new bike too, and riding 1.5-2hours 2x per week. I do have to stretch hands during the ride, it is not really a pain, more like discomfort. Perhaps it is all because of the overuse.
The article you sent link for is interesting. I have tried the stretch exercise it suggests this morning and it seems it helps immediately.
The more I think about the problem, the more I am convinced that it is a combination of overuse and also blood supply restriction to the area due to PMR capillary inflammation. Hopefully I outgrow it over time.
EileenH nick67069
Posted
Sounds like it doesn't it - and when you think about it, the problems with hand position on the bike will have some parallels with rock climbing. Keep stretching!!!
Michdonn nick67069
Posted
Nick, are leaning more toward now? My road have been modified is I no longer lean forward. I don't need the the extra speed. Just an idea. 🙂