PMR, Polymyalgia Rheumatica is a common condition that causes pain, aches, and stiffness in muscles. The word polymyalgia is a combination of two words, where poly means “many” and myalgia means” muscle pain”. Polymyalgia rheumatica is characterized as severe pain in large muscles of your body, especially muscles found in your shoulders and hips. It affects older people, especially people over the age of 60 and 70. In addition, women are more likely to develop this condition in old age than men. Its symptoms get worse in the morning and can get relieved with some physical activity. The exact cause of the condition is still not clear. However, researchers suggested that corticosteroids are good to help reduce the symptoms of Polymyalgia Rheumatica.
What is Polymyalgia Rheumatica?
This is an inflammatory disease that affects people over 60 years of age or more. The condition causes stiffness and pain in your shoulders, neck, and hips. It also affects the larger muscular part of your body, including your upper arms, thighs, and back. The pain can be felt on both sides of the body, in most cases but the pain and stiffness are more severe at the start of the day when you’ve not moved in a while. This stiffness or immobility of muscles; lasts for 20 to 30 minutes in the morning. This pain may be unbearable, sometimes, but it gets improved with some physical activity.
How Common is Polymyalgia Rheumatica?
According to a comparative study, Polymyalgia Rheumatica affects 100, out of every 150,000 people per year in the country. It affects the muscles of people with age more than 60 but its ratio is higher in people with age 65 to 75.
Symptoms of Polymyalgia Rheumatica
Polymyalgia Rheumatica has prominent symptoms such as stiffness and aches in the hips, thighs, neck, and shoulders. The condition often comes quickly, generally taking one or two weeks to shop for exact symptoms. It usually starts after a minor illness like the flu. Then symptoms get worse day by day even if you feel difficulty in dressing, climbing stairs, washing or getting out of bed. These aches are different from the ashes you experience after doing an exercise that your body isn’t used to. Polymyalgia rheumatica is characterized as a condition that causes widespread stiffness and pain in muscles that becomes worse after taking rest. You can try to relieve the symptoms by doing some activity. However, studies also show that its symptoms also go away with time. But sometimes the pain is severe enough to wake you at night.
Sometimes, you may feel unwell or have a slight fever and weight loss due to this condition. Sometimes, tiredness is so overwhelming that it leads to fatigue. Fatigue is a major cause to make you feel depressed, anxious, and low all the time.
Causes of Polymyalgia Rheumatica
Medical research is still not successful in finding out the actual cause of polymyalgia rheumatica. However, studies proposed many theories about its causes. According to those theories, the causes of the condition include:
- Autoimmune diseases (when your immune system, accidentally, starts to attack itself).
- Bursitis (inflamed sacs present in your shoulders and hips).
- Genetics.
- Aging.
- Infections and other environmental factors.
Risk Factors for Polymyalgia Rheumatica
Although researchers have not found the reasons and causes of the condition, they still have information about the risk factors linked with polymyalgia rheumatica, including:
Gender: The condition affects more women than men.
Age: The condition usually affects the people with age above 60. It becomes more severe and overwhelming between the ages of 65 to 75.
Racial and Ethnic Background: People having ancestry in Northern Europe or Caucasian people are more likely to develop the condition. The rate of disease prevalence is higher in these traces than in any other racial or ethnic group of people.
Diagnosis of Polymyalgia Rheumatica
As no specific cause has been discovered for this disease, there is no specific test to diagnose polymyalgia rheumatica. Doctors generally diagnose the condition after knowing about the history of your symptoms and by taking a thorough physical examination of your body. However, some blood tests are used to check for any inflammation in your body and to rule out other conditions.
If you are over age 60 and experience the following symptoms, your healthcare provider may diagnose polymyalgia rheumatica and prescribe a treatment option that may suit your condition. The symptoms to worry about include:
- Stiff or painful muscles in your thighs, shoulders, and hips, especially in the morning may last for at least 20 to 30 minutes.
- A shoulder, neck, or hip pain that you have never experienced before, on both sides of your body.
- Blood test results show high levels of inflammation in your body.
- No blood test showed evidence of swollen joints.
If you have a doubt about the diagnosis of the condition, you may consult with a rheumatologist, who will help you find any complicating factors. However, this step comes after the failure of steroid treatment or if you have experienced side effects of the treatment.
The important thing is that just the presence of inflammation is not enough to confirm the diagnosis of polymyalgia rheumatica. Studies show that inflammation is also a main feature of many other conditions, such as rheumatoid arthritis, autoimmune disorders, or infections.
Your doctor, in such a situation, may go for some more tests to look for the exact signs of other conditions. They may refer you to have ultrasound scans and x-rays.
In addition, other forms of imaging tests may be requested occasionally by your rheumatologist, including positron emission tomography (PET) scans and magnetic resonance imaging (MRI).
Moreover, your doctor may ask you to have a test to diagnose anemia, a condition causing lack of red blood cells that carry oxygen around the body. Because anemia is a common symptom of polymyalgia rheumatica. However, anemia also happens in some other health conditions.
Treatments for Polymyalgia Rheumatica
According to studies, the best treatment for polymyalgia rheumatica can be decided after complete sharing between a healthcare provider and a patient. So that the healthcare professional may know each and every piece of information about your condition and your health history to suggest an effective treatment option accordingly.
If you are experiencing the symptoms of the condition, you should follow a treatment plan tailored to you, that may include:
- An easy approach to education focusing on the impacts of the condition.
- Initial doses of steroids and a proper schedule for when these doses should be reduced and by how much.
- You should contact your healthcare professional when you feel any changes in your condition such as side effects or flares of drugs.
The most common treatment options suggested for the condition include:
Steroids
The most effective treatment for the condition is corticosteroids. Steroids work by reducing inflammation. They have no role to cure the condition but they work to improve the symptoms within two to three weeks. Doctors initially prescribe steroid tablets to treat the condition and symptoms may disappear after three to four weeks of steroid treatment. However, the important thing is to keep the treatment continuing for up to two years, or till the complete vanishing of symptoms.
Research suggests that Prednisolone is the most prescribed steroid which also has some side effects, including osteoporosis, thinning or softening of bones leading to frequent fractures of bones, and rapid weight gain.
People having the following disease conditions are at higher risk of side effects of steroids:
- A cataract.
- High blood pressure.
- Glaucoma.
- Diabetes.
- Peptic ulcer.
- Bone fracture.
If you belong to any of the above-mentioned groups, your healthcare professional may try to prescribe certain drugs along with steroids to reduce any risk associated with excessive use of steroids. Doctors also tend to reduce the dose of steroids after the first four to five weeks of treatment. However, the dose reduction can be made according to your symptoms.
If your symptoms return after dose reduction, they may increase the dose once again, but for a short time, that may be for several weeks. You shouldn’t stop taking steroid tablets suddenly or alter the dose unless advised by your doctor, even if your symptoms completely vanished. This is because your body had lost its ability to reduce steroids on its own while you were taking steroid tablets. Now, it needs some time to resume normal production of natural steroids, called cortisol, after the reduction or complete stoppage of medicines.
In addition, you should go to your doctor for regular checkups after the treatment has stopped and your symptoms vanished completely. Your regular visits may help your doctor to assess for the signs of the condition coming back, or side effects appearing due to drugs. Therefore, your doctor may want to check on your cholesterol level, blood sugar level, and blood pressure. Bone density scan is also performed regularly; to check the strength of your bones.
Moreover, carrying a steroid card will show what dose of tablets you’re on and how long you have been taking them. This step may help you when you visit another doctor when you’re away from home or on a journey. You can avail the steroid card from a pharmacy, easily.
Prevention of Polymyalgia Rheumatica
Researchers are still trying to find out the exact cause of polymyalgia rheumatica. The exact cause of the condition is not understood therefore it is not possible to prevent the condition. However, you can take preventive measures to stop osteoporosis.
Outlook and Prognosis
The symptoms of the condition can be lessened or even completely disappear after the proper treatment. This can happen within days if the treatment remains consistent. Early diagnosis and proper treatment can help increase your chance of quick recovery from the condition.
In addition, researchers have also discovered that people living with polymyalgia rheumatica are at higher risk of developing a condition called atherosclerosis. However, this condition is not life-threatening and does not seem to affect your life expectancy. Severe disability or impairment are rare.
Studies also showed that with the help of effective treatment patterns, the symptoms of polymyalgia rheumatica can be resolved within days. The total duration for treatment is around two years but in severe cases the treatment lasts for a longer duration and sometimes, the patients need a lifelong treatment with a low dose of prednisone to prevent the recurrence of the symptoms.
Moreover, polymyalgia rheumatica generally doesn’t get better without proper treatment. But in some cases, the condition may get better on its own after 10 to 12 months. In severe cases, it takes four to five years to complete eradication of the disease.
Living with Polymyalgia Rheumatica
You can take care of yourself while having the symptoms of the condition by taking steps to manage your symptoms and side effects of drugs. You should have to take your medications as prescribed by your doctor and maintain a balanced diet plan. Getting some form of physical activity everyday can also help to relieve the symptoms. Once you get success in reliving your aches and pains, you can return to all of your normal life activities.
If you experience any of the following during your treatment, talk to your doctor immediately:
- Softening of bones.
- Lesser bone density.
- Sleeplessness.
- Constant high blood pressure.
- Sudden weight gain.
- Cataract.
- Bruising of your skin.
Polymyalgia rheumatic often overlaps with giant arteries, let your dictator know if you experience any symptoms of the disease, including:
- Jaw pain.
- Fatigue.
- Scalp tenderness.
- Vision changes.
- Headaches.
- Loss of appetite.
- Fever.
Conclusion
Polymyalgia rheumatica symptoms make it harder for you to move or function normally. Experiencing severe muscle pain and stiffness in muscles are the prominent signs of the condition. As it is difficult to diagnose the disease, your healthcare professional may help to diagnose it with the help of knowing your health history and keeping a check on the symptoms you experience.
Therefore, it is necessary to let your provider know all the details about your symptoms so that they can suggest the best medications or steroids for your condition.
