What is Polymyalgia Rheumatica?
Polymyalgia rheumatica is an inflammatory condition that causes stiffness and muscle pain around the neck, arms, hips, and shoulders. The condition affects adults over the age of 50, especially women.
Causes of Polymyalgia Rheumatica
The cause of polymyalgia rheumatica is not known but a combination of genetic and environmental factors increases your risk of developing the disorder.
Symptoms of Polymyalgia Rheumatica
The most common symptoms include neck pain and stiffness which may slowly spread to other areas of the body such as the hips, shoulders, and thighs. It may also cause other symptoms which include:
- Extreme tiredness
- Anemia
- Depression
- Malaise
- Limited range of motion
- Loss of appetite
- Sudden weight loss
- Low-grade fever
The symptoms appear suddenly and tend to be worse in the morning but can improve as the day goes on or with increase inactivity. If not treated the pain and stiffness may be so severe that it becomes difficult to perform everyday activities such as dressing, washing, falling asleep or getting into the car.
Diagnosis of Polymyalgia Rheumatica
Your doctor diagnoses polymyalgia rheumatica by performing a physical examination of your arms, neck, and legs to evaluate your range of motion. Your doctor may also recommend the following tests to confirm the diagnosis and determine the extent of your condition:
- Blood tests can rule out other conditions and check for signs of inflammation. These tests determine your erythrocyte sedimentation rate or ESR and C-reactive protein levels. An abnormally high ESR and C-reactive protein levels suggest an inflammatory process.
- Ultrasound may be ordered to check for inflammation in your joints and tissues and to rule out other conditions with similar symptoms.
- A biopsy may be obtained to confirm the diagnosis since there is a link between polymyalgia rheumatica and temporal arteritis. However, a biopsy is performed only if your doctor suspects an inflammation in the blood vessels.
Treatment for Polymyalgia Rheumatica
Polymyalgia rheumatica currently has no cure. Therefore, treatment involves the management of symptoms. Your doctor will recommend a low-dose corticosteroid, to help reduce the inflammation. Initially, a moderate dose is prescribed which is gradually reduced over time if symptoms are improving. Although corticosteroids are effective in treating polymyalgia rheumatica, these drugs do have side effects. To reduce your risk of side effects, your doctor may recommend:
- Calcium and vitamin D supplement
- Physical therapy to increase your range of motion and improve your strength
- Eating a healthy diet and limiting salt intake to prevent high blood pressure
- Regular exercise to prevent weight gain and strengthen your bones and muscles
During treatment, your doctor will carefully monitor your health.
If symptoms do not improve with medication, your doctor may order additional tests to check for other rheumatic disorders, such as rheumatic fever and osteoarthritis.
