Posted , 13 users are following.
I have been tapering steroids for 18months and am down to 5mgs from 20mgs. Suddenly now I have pain in my wrist joints....not really bad but definitely there. My ESR and CRP levels are normal.
Is this my body adjusting to the lower dose and should I just push through it?
Any thoughts anyone?
0 likes, 5 replies
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edward_80796 pritch60
Posted
amkoffee pritch60
Posted
With the exception of when I was first diagnosed with PMR my pain always starts in my wrists and forearms. I didn't even think this was a PMR symptom until I learned here and had it confirmed with my rheumatologist that it is indeed something that can happen with PMR. But I have to say that the pain in my arms and wrists are quite painful. The longer I go without taking my prednisone in the morning the worse it gets and the longer it takes for me to get results when I do finally take my prednisone. Fortunately this has only happened about three times as I can recall. Only once was it my own fault. The other times I was in a hospital where they were getting in my medication on their time schedule and I had to say something to them.
Now back to you... You could try increasing your dose and see if that helps. Or since your inflammation markers are normal again I wonder if it would help to split your dose up during the day.
EileenH pritch60
Posted
Difficult to say - if it is steroid withdrawal discomfort it will improve often the next week or so.
Your ESR/CRP are normal because you have been on high enough a dose of pred to manage the inflammation so don't signify very much. It is possible you are now reaching a dose that ISN'T enough for the first time and so the inflammation is beginning to break through and cause symptoms. Certainly for me my wrists were involved originally and wrist pain is the first sign of a flare of symptoms. There are others who say the same. However - pred will mask OA pain at higher doses but it will break through at lower ones.
If it is your body getting used to the lower dose it will improve over the next couple of weeks and if that happens yes, push through but don't reduce any more until the pain is gone. If, on the other hand, it gets worse in the next few days or so, it would be better to go back to the last dose for a few weeks before trying possibly a smaller or slower reduction. This is a low dose and there is no hurry - often postponing a reduction will work next time round.
But never forget - you are not heading relentlessly for zero, you are looking for the lowest dose that manages the symptoms as well as the starting dose did. PMR lasts an average of nearly 6 years and few patients get off pred in under 2 years. The lower you get the nearer you will be to that dose - don't rush and don't push!
pritch60 EileenH
Posted
andypolly pritch60
Posted
About a month ago I got severely painful and swollen knuckles and pain in my wrists. Doc implied that this could be rheumatoid arthritis. Blood tests indicators for RA (There are 2, but I can't remember their names!) both very low. My PMR indicators have been very low since I started Pred. I'm seeing Rheumy next week hoping it's just a PMR flare. Upped my Pred from 7 to 10 and the pain slowly went away. Diagnosed with PMR 2.5 years ago. None of us with PMR wants RA as well!