Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, primarily in your neck, shoulders, upper arms, hips and thighs. Symptoms of polymyalgia rheumatica (pol-ee-my-AL-juh roo-MA-ti-kah) usually begin quickly over a few days.
Most people who develop polymyalgia rheumatica are older than 65, and it rarely affects people younger than 50.
Anti-inflammatory drugs called corticosteroids improve the symptoms of polymyalgia rheumatica, but these drugs require careful monitoring for serious side effects.
Polymyalgia rheumatica is related to and may coexist with another inflammatory disorder called giant cell arteritis, which can cause headaches, visual impairment, jaw pain and other symptoms.
The signs and symptoms of polymyalgia rheumatica include:
When pain and stiffness first appear, it's common to have more general signs and symptoms, including:
When to see a doctor
The cause of polymyalgia rheumatica is not well understood. The pain and stiffness result from the activity of inflammatory cells and proteins that are normally a part of your body's disease-fighting immune system.
Inflammation is usually a response to injury or disease, but in some disorders — known collectively as rheumatic diseases — inflammatory activity occurs when there is no apparent need for the response.
In polymyalgia rheumatica, the inflammatory activity seems to be concentrated in tissues surrounding the affected joints. The muscle pain associated with the disorder is called referred pain, or pain that extends from joints to nearby muscles or other tissues.
Giant cell arteritis
Polymyalgia rheumatica and giant cell arteritis may, in fact, be variations of the same disease. Studies have produced varying results, but the overlap of diagnoses is significant:
Risk factors for polymyalgia rheumatica include:
Symptoms of polymyalgia rheumatica can greatly affect a person's ability to perform everyday activities. The pain and stiffness may contribute to difficulties with the following tasks:
These complications can affect a person's health, social interactions, physical activity and general well-being.
Preparing for your appointment
If you're experiencing aches, pains or stiffness in joints or muscles, you're likely to see your primary care doctor first. You may be referred to a specialist in inflammatory disorders of muscles and the skeletal system (rheumatologist).
You may want to bring a friend or relative to your appointment. This person, in addition to offering support, can write down information from your doctor or other clinic staff during the appointment.
What to expect from your doctor
Prepare a list
Tests and diagnosis
Your answers to questions, a general physical exam and the results of tests can help your doctor determine the cause of pain and stiffness.
Some tests will screen for a number of factors, such as viral infections or changes in certain hormone levels, that can rule out certain conditions or lead to a diagnosis other than polymyalgia rheumatica. Other tests will assess the profile of various blood components that can indicate inflammatory activity or chronic disease in your body.
Test results particularly relevant to making a diagnosis of polymyalgia rheumatica include the following:
Monitoring for giant cell arteritis
If your doctor suspects a diagnosis of giant cell arteritis, he or she will order a biopsy of the artery in one of your temples. This procedure, performed with local anesthesia, removes a tiny sample of the artery, which is then examined in a laboratory for signs of inflammation.
Treatments and drugs
Relief from pain and stiffness should occur within the first two or three days. If you're not feeling better in a few days, it's likely you don't have polymyalgia rheumatica. In fact, your response to medication is one way your doctor can confirm the diagnosis.
After the first two to four weeks of treatment, your doctor will gradually decrease your dosage depending on your symptoms and the results of sed rate and C-reactive protein tests. The goal is to keep you on as low a dose as possible. Most people with polymyalgia rheumatica need to continue the corticosteroid treatment for two to three years.
You will have frequent follow-up visits to monitor the treatment effect and assess for possible side effects.
Monitoring side effects
Calcium and vitamin D supplements
Lifestyle and home remedies
Healthy lifestyle choices can help you manage the side effects that may result from corticosteroid treatment:
Last Updated: 2010-12-04
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