Polymyalgia Rheumatica

28th June 2007 at 12:28 BST by Dr C.A.Jenner MB BS, FRCA. Permalink.

This article explains the various aspects of polymyalgia rheumatica.

Polymyalgia Rheumatica

Introduction

Polymyalgia rheumatica (PMR) is a condition typically characterized by a severe pain and stiffness in certain muscles of the body.

Adults over the age of 50, especially women are more likely to develop polymyalgia rheumatica. Though it can occur in all ethic groups, polymyalgia rheumatica is relatively more common in people of European ancestry.

Giant Cell Arteritis

The condition of polymyalgia rheumatica can be closely associated with another condition, know as the Giant Cell Arteritis or the temporal arteritis. This condition is characterized by an inflammation on one side of the head, leading to headaches and scalp tenderness.

In some cases, this condition can also affect blood vessels in the eye and further lead to vision disturbances. If not treated properly in time, the condition of Giant Cell Arteritis can even lead to a loss of vision.

Key Symptoms

The most prominent characteristic of polymyalgia rheumatica is that it has an abrupt onset of symptoms.

The stiffness associated with the condition of PMR is most evident in the morning, which makes it even difficult to get out of the bed. However, inspite of the severity of pain and stiffness in the muscles, there is no loss of power in the muscles. Hence, no muscle weakness is felt.

Here we list some of the other common symptoms associated with polymyalgia rheumatica.

• Low fever
• Unexplained weight loss
• Fatigue
• Depression
• Loss of appetite
• Night sweats

Diagnostic Methods

The main aim of the diagnostic methods used for polymyalgia rheumatica is to rule out the possibility of rheumatoid arthritis and polymyositis. The following series of tests and examinations are generally applied to detect the presence of polymyalgia rheumatica.

Blood tests might be performed for the following purposes:

• To rule out rheumatoid arthritis, as the patients of polymyalgia rheumatica do not have a rheumatoid factor antibody, unlike those of the other disease
• To check for inflammation in the body by measuring the erythrocyte sedimentation rate .i.e. how quickly the red blood cells settle to the bottom of a test tube
• To check the red blood cell count, as the patients with polymyalgia rheumatica often have a low red blood cell count but more than normal number of platelets
• To check for the presence of Giant Cell Arteritis, for instance, biopsy of the temple arteries

In addition, a thorough examination of the medical history of the patient is also carried out.

Treatment Options

Various types of treatment methods are available for relief from the symptoms of polymyalgia rheumatica. Here we've listed the main amongst them.

A) Medication

The following types of medicines are generally administered:

• NSAIDs – The non-steroidal anti-inflammatory drugs are a type of medication which helps to reduce pain and swelling and decrease stiffness in the affected area.
• Oral Cortisone – This is the most often prescribed medicine for polymyalgia rheumatica and Giant Cell Arteritis. It is basically a steroid that significantly reduces inflammation in the affected area.

B) Exercise

Exercises help by reducing pain and keeping muscles from becoming weak. It is important to observe the basic principles of pacing.

The three most effective forms of exercise include:

1. Range of motion exercises, for reducing stiffness and helping in keeping the joints moving
2. Strengthening exercises, to maintain or increase the muscle strength
3. Endurance exercises, to strengthen the heart and give energy. Such exercises include walking, swimming and cycling

C) Heat/Cold Therapy

Applying heat considerably helps in relaxing the aching muscles and reducing pain and soreness. A hot shower is extremely helpful in this condition.

Similarly, applying cold also helps to lessen the pain and swelling. Putting an ice pack on the sore area can be quite effective.

Self-Care

It is important to protect your muscles and joints and be generally cautious in the state of polymyalgia rheumatica.

Here we list some of the main self-care measures that can be adopted.

• Take short and frequent breaks when doing a heavy and repetitive task
• Be careful when using your back, arms and legs to avoid putting stress on the muscles and joints
• Use helpful devices such as a cart for carrying material like grocery bags and the like
• Avoid gaining excessive weight
• Follow adequate pacing and relaxation techniques

Appointments and more information

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