PMR and RA treatment question

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.

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!!!

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. 🙂