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wrists and hands hurt every morning, help

Posted , 11 users are following.

marilyn79703
marilyn79703

Have polymyalgia now for about 1 year. Am down to 4mg prednisone and 5 pills of methotrexate. Now my hands and wrists every morning hurt so bad can hardly use them. My fingers on 1 hand go numb. My other pain is there in the morning but goes some what away as day goes on. Anyone else have problem with hands and wrists or is this not related to the pmr. Any info would be great.

3 likes, 14 replies

14 Replies

  • pat38625
    pat38625 marilyn79703

    Posted

    Hi Marlyn, sorry to hear you are having a time of it.  I have PMR just diagnosed in November there.  There will be someone along in a while to answer your questions and give you advice, support and advice.  Hang on in there, a great forum and great contributors, who have been there and have many t-shirts.     Pat
  • EileenH
    EileenH marilyn79703

    Posted

    When I was flaring because the pred dose was too low it always started in my wrists, especially at the base of my thumb. A recent clinical study has found PMR does also involve hands. 

    On the basis of what you have said here, I would say your dose of pred is too low - there are several ladies who have been put on methotrexate, reduced to these sort of pred doses and promptly developed flares of the PMR and had to return to higher doses. There is no reliable clinical proof that mtx helps in PMR and it has been removed from the latest lot of recommendations from the BSR. Is your doctor prepared to allow you to try a slightly higher dose of pred? To be at 4mg after a year is VERY fast, experts have assessed in the past that about a quarter of patients may get off pred in under 2 years but are at a higher risk of having a second dose later. I would prefer a bit longer on pred and less pain myself.

    It is also possible that you have osteoarthritis in your hands that was being controlled by the pred and is returning now you are at a lower dose. Mtx does nothing for that. I also know a couple of ladies who experienced that. 

  • tina-uk_cwall
    tina-uk_cwall marilyn79703

    Posted

    Hi Marilyn, yes pre diagnosis I had pain in both my thumbs and the outside of both wrists. As soon as I started the prednisone the pain went. Just prior to Christmas I had a flare and the pain returned to my thumbs and left hand outside wrist. Also about 2 years before I had any signs of PMR I think I was developing carpel tunnel especially in my left hand. When I washed up my wrist/hand would sort of go numb and my wrist would clunk into position. But those symtoms have also gone. Christina 
  • gillian81509
    gillian81509 marilyn79703

    Posted

    More like r a

    What Rheumy say and xrays show

    • barbara75814
      barbara75814 gillian81509

      Posted

      I agree with you, gillian--sounds like an examination and tests by a rheumatologist are urgently called for.

      Barbara

  • pat38625
    pat38625 marilyn79703

    Posted

    I have never had any type of pain in small joints like wrists, ankles, fingers.  The only way I can describe my pain is like all the muscles and bones fused together and turned into cement.  I have had no pain in kness and below.  Trying to get in and out of bed, pain level 12 out of 10.  Trying to get into the shower and out another nightmare and pain level 12 out of 10.  Couldn't turn in bed pain level 15 out of 10.  Trying to get undergarments on another nightmare, but I had to do those things as I have a 32 year old son at home and would never ever ask him to help.  I kept my dignity even though I was in sheer agony.  The 20mg of pred took most pain away, am now down to 17.5mg but still have muscle soreness in my thighs.  We are all different I mean our symptoms (PMR) while the auto immune illness is still the underlying factor with no answers.  

     

  • murray2
    murray2 marilyn79703

    Posted

    Hi Marilyn, pain in hands and wrists has been my experience also. I was initially diagnosed with PMR but when referred to a rheumatologist he said I had inflammatory arthritis and later rheumatoid arthritis. I have been on 20mg of methotrexate for over a year and currently take 13.5 mg of prednisone a day. I took 15 mg pred for 6 weeks. I also take 2000 mg of sulphasalazine a day ( for 2 months now). I have previously reduced the pred to 4 mg but always had the hand and wrist pain. With the increase in pred dose and the sulphasalazine I am the best I have been. I am not sure whether it is the increase in pred or the sulphsalazine that has helped. I am now reducing the pred dose slowly.
  • julian.
    julian. marilyn79703

    Posted

    it hadn't occurred to me that hands may not be involved in PMR. Though I'll always consider my diagnosis. Pre pred my hands were visibly swollen. And stiff. With pred (now at 5mg) no swelling but stiff. In the last couple of months pain in some fingers between joints. A diffuse pain. Not sufficient to concern me. Order of magnitude less than the excruciating arm pain pre pred. No wrist pain.
    • EileenH
      EileenH julian.

      Posted

      That is what my hands were like with PMR - and I do not have another form of arthritis whatever a couple of rheumies had to say! On my way down the pred dose it returned if I went to a dose that was too low at the time and just 1mg difference was enough to do it then. It never got as bad as at the beginning but that was because I didn't let it.
  • bobofbristol
    bobofbristol marilyn79703

    Posted

    Hi Marilyn like you I've had PMR for about a year.  Started at 15mg pred. and over the last 24 weeks have been reducing at the rate of 1mg every 2 weeks. Got down to 4mg with no problems.  When I dropped to 3mg symptoms started in my hands just as you've decribed.  I'm back up to 4mg now and hoping for the best. Bob
    • EileenH
      EileenH bobofbristol

      Posted

      That suggests that your PMR is still active and you have found your long term maintenance dose. Whatever - it is such a low dose it won't be doing a lot of harm and I'd accept it happily!!
  • tony09890
    tony09890 marilyn79703

    Posted

    I was diagnosed about four weeks ago and put on 15mgs of prednisone.   I found if I did nothing other than brush my teeth in the morning the pain was much lowered; however, any sort of activity during the day and the pain grew exponentially at night and in particluar the mornings.   What sent me to the Doc in the first place was the pain in wrists and forearms as well as elbows, upper arms and nec, my left thumb is also extremely painful and I'm finding my back is now becoming increasingly painful around the scapula and ribs.   Yesterday my GP told me to wean off prednisone as he now doesn't believe I have PMR, says 15mgs of pred should have cleared the symptoms and symptoms (wrist, forearm, etc) are not typical PMR.   Not much point in finding another Doc because unfortunately I don't think many in the medical profession, particularly GPs,  have a clue about PMR.   I have a referral to a Rheumatologist but can't get in to see him until Xmas.
    • EileenH
      EileenH tony09890

      Posted

      They may not be typical but I had hand (especially the thumb joints), wrist and elbow pain along with my PMR - initially we had assumed it was RSI but it was tendonitis and synovitis due to PMR that was ignored for so long. It took about 6 months of pred for that to fade to just occasional stabs. I found a wrist brace helped a lot. A study in Leeds last year established that, yes, PMR can involve hands and feet.

      I also had pain into my scapula and ribs which was (it was eventually worked out) due to myofascial pain syndrome which was causing referred pain into upper arms and legs as well. It can mimic a lot of PMR symptoms. It responds well to local cortisone shots into the trigger spots or manual mobilisation of these trigger points which are in pairs on either side of the spine in shoulders, about rib level and low back. These trigger spots are concentrations of cytokines - the same substances that cause the inflammation in PMR.

      Since you have to wait so long to see a rheumy why not try a few sessions of Bowen - it may not sort it completely but it may well reduce some of the pain. You will know if it helps in up to 3 sessions, if there is no change by then it probably won't change and you can stop. Most people find a difference after the first - Lodger will tell you she had to be supported into the room by a friend on one side and a walking stick on the other - there wasn't room for the zimmer frame or wheelchair in the car - but she walked out after one hour and forgot the walking stick! It kept me upright in the 5 years I had PMR (definitely) but no pred.

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