Terrible cramping in hands and feet

Bones, joints and muscles
1

Hi - I've been on prednisone and now methylprednisolone for my PMR for about 18 months. I'm now on 17.5mg and recently have been experiencing horrendous cramping in my hands and feet. My hands cramp so bad it goes into a claw and is very painful and I lose use of the hands during this time. 

I have been drinking tonic water for the quinine and taking magnesium supplements but the problem persists. I also take a water pill for HBP but try to make sure I drink enough to stay hydrated. 

Any suggestions ?

2

Hi scotth42.

I find a teaspoon of American mustard ( the mind yellow stuff) works wonders. for cramping. I know a few that swear by it too.

Hope it helps.

3

The “water pill” depletes potassium. Bring it to your doctor’s attention. 

4

Scott, I just checked a professional drug interaction database and found the prednisone when taken together with a water pill such a hydrochlorthiazide can cause potassium imbalance. Have your prescribing doctor check this; drinking TOO much water can deplete you further. This is not a diy fix.

5

Thank you...easy enough to try 

6

Thank you...I will question him about it.

7

Yeah for America!

8

scotth42,

          I had the same problem but it quickly went away. Only happened two ot three times and then gone.

9

Have you had your blood electrolytes and calcium checked? Not only low magnesium can cause cramp and has been mentioned a diuretic plus pred means you should have your potassium checked regularly.

To be at 17.5mg after 18 months is still rather high - it is commonly a starting dose and most doctors would be concerned if you hadn't reduced more than that after 18 months. Is it "just" PMR.

10

Have been lower on the prednisone but had to increase due to flare ups from other issues. Trying to reduce again. 

Contacted rheumy about having electrolytes checked. In the meantime eating foods high in potassium. 

11

Your PCP/GP can do that if it is easier.

12

Potassium levels are normal......and just recalled my rheumy has been ordering blood tests periodically to check everything. 

13

Are you sure your pred is enough? PMR caused me to have cramps in my hands and that is where I feel it when a flare is threatening - the ball of my thumb becomes painful and can cramp if I try to hold something "wrong".

But also do check with your rheumy - it might be something else. Although there was a thread a few months ago where someone's initial symptoms involved their hands cramping and curling as you describe and because it was left it just got worse. Her doctor refused to have it that PMR affects hands. Leeds reserach group looked at it - yes it does, and feet too.

14

I read that thread and I couldn't believe her hands were cramping so bad that they were curling. That sounds just horribly painful. Fortunately my doctor does know that hand pain can be a symptom of PMR. But she does refuse to believe that feet can also be a part of PMR. Because I have almost as much pain in my feet as I do in my hands. I have purchased some compression socks that my husband will put on my legs when my feet and legs are hurting. But when my legs are involved I know that's my sciatica. But this socks do seem to help some. With the joint pain I'm currently suffering I put my socks on last night and it actually helped with the ankle and Joint stiffness and pain.

15

Hi,  I'm also plagued with hand and feet cramps mostly in the morning, just as I am awakening, but moreso, the cramps occur in my toes, arches, through the ankle and up my lower legs, mostly on the left leg, but the right leg is catching up.

I was diagnosed PMR in Nov. 2016.  Was put on 20mg, Prednisone which relieved my symptoms within a day.  Since then I reduced to 15mg, then 10mg, (and a short stint of 7.5mg which left me in pain - Rheumy's suggestion to get off the Pred more quickly... duh, nope), so I informed my GP and went back up to 10mg in Feb, '17, where I have been since. I'm still achy all the time, with bouts of random pain, roaming from shoulder to shoulder, upper arm muscles... but the new symptoms are these leg/feet cramps! Toes cramp into claws, locked in a frozen position, until I get up and walk... it's the only way I can force the muscles to stretch back out, is to put my weight on them and walk, and walk and walk.... Usually by 5 min later, they are gone and only an ache is left (lower legs are the same way). It's like "charley horse" cramps... they are so painful, and just in the morning as I awaken.

My leg/feet/toe cramps started about mid-May.  First, I thought it was because I was over-doing swimming or too much walking... thinking lactic acid buildup... but it didn't ring true.  Lactic acid from overworked muscles, wouldn't show up after 6-8 hours of sleep!  And they seem to be getting worse.  One morning I felt the cramp run from my toes, included my leg (left side this time) all the way to my pelvis, my hamstrings were like rocks!  Incredible pain!

Three days later, I saw my Muscular Therapist, and told her of my leg cramps... she said my hamstrings were still hardened... and it was kinda painful when she worked on them, but she was able to relieve the most of the hardness to the muscles.

I just had my annual physical.  My lab tests came back in normal ranges for potassium, magnesium and other blood parameters, except my cholesterol, which has been climbing higher over the last few years, just popped over into the "high" range.

Water is my favorite drink.  Tea and coffee are my next faves.  So I'm not dehydrated.  Prednisone has added an extra 20 lbs "water weight" on me, and my joints are unhappy about it.  I may have to see about a "water pill".  I've just signed up with a nutritionist to help me with an anti-inflammatory, lower-my-cholestrol, lower carb, and lower my weight diet.  Hope this will help, too.

I so understand about the muscle cramps.  Not sure what to suggest, either.  Tumeric in mustard really upsets my stomach so I'm not taking it anymore... it didn't help the morning leg cramps, either.

My next Rheumy visit is Dec 13.  I may have to find some other Dr as she is often away at conferences, and only has 3 days a week appt's.  Altho, she is very knowledgeable about PMR, I'd like a Dr. that is around more often than off for 2 weeks frequently for these events.

If anyone has suggestions... I'd be happy to try anything to rid of these leg/toe cramps!

Thx, marla

16

Just because your blood magnesium level is right doesn't mean the level in the muscles is so it may be worth trying magnesium supplements.

You need to be careful about diuretics with pred - it makes you lose potassium and calcium through the kidneys so you should be put on a potassium sparing diuretic if at all and your blood checked regularly. I find I retain a lot of fluid if I eat any food prepared with salt - and are you SURE your weight gain is all fluid? Pred causes fat deposits and weight gain is common. Cutting carbs drastically helps - and also helps fluid retention.

17

My creaming seems to come and go with no rhyme or reason. I recently tried a delicious chewable "high absorption" magnesium. It gave me palpitations every time I took it. If I talk half a tablet that dose doesn't result in palpitations. I do not have heard disease after a complete work up but elevated magnesium can cause arrhythmia.

18

Corrections: cramping instead of "creaming". Take instead of "talk"; heart disease instead of "heard disease".

19

I've recently started wearing compression socks when my lower legs and ankles ached. I don't know if it'll work for your feet cramping but you might give it a try. After all compression socks are not very expensive so it would be a low-cost low-risk experiment.

For your hands you might try copper infused gloves. You can find them on Amazon. I don't know if you can find them locally or not. And that would be a low-cost low-risk experiment too.

20

Hi EllenH!  Thank you for your insights.  I do take extra Magnesium (400mg), but I have to be careful if I take more than one a day.  I get the "trots" for a day.  But I hear you.  My Dr said the same thing of Calcium.  Blood levels may be ok, but (as in Ca) it's not necessarily getting into the bone.  I can believe that of Mg, too.

We eat foods that we prepare, make our own soup broth, and buy organic vege's and eggs.  Meats are from local butchers, grass raised, antibiotic-free.  if we use a canned item, it's always low sodium.  I can't remember the last time I bought a container of salt... we just don't use it.

Nope, not sure the Pred is causing water weight gain.  But I'm packing it on like I was going into hibernation!!!  I believe it when you say it can cause fat deposits. The weight gain is already there.  I am trying to cut carbs...  that is a tough one!  Getting rid of the fat deposits is going to be harder than shedding water weight.  :::sigh:::

Thank you for your time to respond!

Marla