To taper or not to taper... that is the question
Posted , 12 users are following.
I went for usual 3 month checkup with rheumi and all tests are fine, there is no measurable inflammation ( withing limits). I dont have much of the usual PMR symptoms except the morning stiffness, which goes away after the walk. IThe only problem I have is that my hands are weak and hurting to the point that it is hard to open bottle ( for example). Rheumi thinks that it may be related to PMR and would like me to stay at the same level - 3mg. I have been at this level for couple of months. As you all know I exercise at pretty decent level and have no issue at all. So two questions:
Is hands pain related to PMR ? It started when I dipped below 4mg back in the spring time. Or is it something totally unrelated. Blood test does not show any indication of rheumatism.
and second question is should I try to reduce pred or not? For me it is much easier to do taper during warm weather, this is why I am asking.
0 likes, 36 replies
Anhaga nick67069
Posted
This is only my gut feeling. If the hand issue has been developing recently, not part of your initial PMR suite of symptoms, I'd guess it may have something to do with the pred itself weakening muscles. Given that you feel well otherwise, why not try a very cautious DSNS .5 mg taper and see what happens? And, is there something you do which could be stressing your hands? It could be the most obscure thing which would never bother a person without PMR/pred.
nick67069 Anhaga
Posted
EileenH nick67069
Posted
My hand pain has always been related to PMR. But it is difficult to know really - it could be something else. If you mean the rheumatoid factor is negative/low that doesn't necessarily mean it isn't RA - there is a form described as seronegative RA but there are fairly strict criteria to fulfil to say it is RA without blood markers. It doesn't sound as if you would qualify!
As for reducing - you are the only person who can know. Try it and see! But it is a very low dose - no worries if you stay there.
nick67069 EileenH
Posted
Your thoughts?
Anhaga nick67069
Posted
I'm pretty sure pred is often used in the management of RA, although they like to phase it out in favour of other meds like mtx.
Anhaga
Posted
I've just remembered my cousin with RA loves when she takes pred (not very often and I'm not sure why she needed it not long ago) because it makes her feel so well!
ptolemy Anhaga
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Anhaga ptolemy
Posted
Okay, that must have been it then. I remember years ago overhearing part of a conversation she had with someone else who had some sort of inflammatory arthritis, and the gist of it must have been how imperative it was she get off pred as soon as possible. This is long before I had PMR so the conversation was rather meaningless to me at the time. As RA is lifelong and responds to other meds I guess pred isn't desirable for long term use. However this same cousin had to discontinue mtx a while ago because of liver markers, which are now back to normal There's always something!
nick67069 Anhaga
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Anhaga nick67069
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EileenH nick67069
Posted
Sorry for the delay in replying - I'm travelling!
Pred is used to get flares of RA under control until the DMARD kicks back in. So it isn't proof positive...
EileenH Anhaga
Posted
If you have an inflammatory arthritis that isn't causing joint damage then low dose pred can be and is used to manage it long term - much as we do with PMR. The DMARDs are used to reduce the risk of potential joint damage. I found a paper about it a few months ago - can't remember the reference though,
Bethune nick67069
Posted
My RA is 99% symptom free, but I have great trouble lowering my prednisone below 15, and especially less than 10, without experiencing PMR symptoms.
Perhaps they could MRI your hand joints to help with an accurate Diagnosis.
nick67069 Bethune
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jillian92038 nick67069
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Hands below 3? Interesting.