Disease: Polymyalgia rheumatica

Overview

Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders. Signs and symptoms of polymyalgia rheumatica (pol-e-my-AL-juh rue-MAT-ih-kuh) usually begin quickly and are worse in the morning.

Most people who develop polymyalgia rheumatica are older than 65. It rarely affects people under 50.

This condition is related to another inflammatory called giant cell arteritis. Giant cell arteritis can cause headaches, vision difficulties, jaw pain and scalp tenderness. It's possible to have both conditions together.

Source: http://www.mayoclinic.com

Symptoms

The signs and symptoms of polymyalgia rheumatica usually occur on both sides of the body and might include:

  • Aches or pain in your shoulders
  • Aches or pain in your neck, upper arms, buttocks, hips or thighs
  • Stiffness in affected areas, particularly in the morning or after being inactive for a time
  • Limited range of motion in affected areas
  • Pain or stiffness in your wrists, elbows or knees

You might also have more-general signs and symptoms, including:

  • Mild fever
  • Fatigue
  • A general feeling of not being well (malaise)
  • Loss of appetite
  • Unintended weight loss
  • Depression

When to see a doctor

See your doctor if you have aches, pains or stiffness that:

  • Is new
  • Disrupts your sleep
  • Limits your ability to do your usual activities, such as getting dressed

Source: http://www.mayoclinic.com

Causes

The exact cause of polymyalgia rheumatica is unknown. Two factors appear to be involved in the development of this condition:

  • Genetics. Certain genes and gene variations might increase your susceptibility.
  • An environmental exposure. New cases of polymyalgia rheumatica tend to come in cycles, possibly developing seasonally. This suggests that an environmental trigger, such as a virus, might play a role. But no specific virus has been shown to cause polymyalgia rheumatica.

Giant cell arteritis

Polymyalgia rheumatica and another disease known as giant cell arteritis share many similarities. Many people who have one of these diseases also have symptoms of the other.

Giant cell arteritis results in inflammation in the lining of the arteries, most often the arteries in the temples. Signs and symptoms include headaches, jaw pain, vision problems and scalp tenderness. If left untreated, this condition can lead to stroke or blindness.

Source: http://www.mayoclinic.com

Diagnosis

A physical exam, including joint and neurological exams, and test results can help your doctor determine the cause of your pain and stiffness. During the exam, he or she might gently move your head and limbs to assess your range of motion.

Your doctor might reassess your diagnosis as your treatment progresses. Some people initially given a diagnosis of polymyalgia rheumatica are later reclassified as having rheumatoid arthritis.

Tests your doctor might recommend include:

  • Blood tests. Besides checking your complete blood counts (CBCs), your doctor will look for two indicators of inflammation — erythrocyte sedimentation rate (sed rate) and C-reactive protein. However, not everyone with this condition has elevated levels.
  • Imaging tests. Increasingly, ultrasound is being used to distinguish polymyalgia rheumatica from other conditions that cause similar symptoms. MRI can also identify other causes of shoulder pain, such as joint changes.

Monitoring for giant cell arteritis

Your doctor will monitor you for signs and symptoms that can indicate the onset of giant cell arteritis. Talk to your doctor immediately if you have any of the following:

  • New, unusual or persistent headaches
  • Jaw pain or tenderness
  • Blurred or double vision or visual loss
  • Scalp tenderness

If your doctor suspects you might have giant cell arteritis, he or she will likely order a biopsy of the artery in one of your temples. This procedure, performed during local anesthesia, involves removing a small sample of the artery, which is then examined for inflammation.

Source: http://www.mayoclinic.com

Complications

Symptoms of polymyalgia rheumatica can greatly affect your ability to perform everyday activities, such as:

  • Getting out of bed, standing up from a chair or getting out of a car
  • Combing your hair or bathing
  • Getting dressed

These difficulties can affect your health, social interactions, physical activity, sleep and general well-being.

In addition, people with polymyalgia rheumatica seem to be more likely to develop peripheral arterial disease, although it's usually mild and responds well to treatment.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

Over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), are not usually recommended for easing the signs and symptoms of polymyalgia rheumatica.

Healthy lifestyle choices can help you manage the side effects that may result from corticosteroid treatment:

  • Eat a healthy diet. Eat a diet of fruits, vegetables, whole grains, and low-fat meat and dairy products. Limit the salt (sodium) in your diet to prevent fluid buildup and high blood pressure.
  • Exercise regularly. Talk to your doctor about exercise that is appropriate for you to maintain a healthy weight and to strengthen bones and muscles.
  • Get enough rest. Rest is necessary to give your body time to recover for exercise and activities of daily living.
  • Use assistive devices. Consider using luggage and grocery carts, reaching aids, shower grab bars, and other assistive devices to help make daily tasks easier.

Source: http://www.mayoclinic.com

Coping and support

Even though you'll start to feel better soon after you begin treatment, it can be frustrating having to take medication daily, especially one that can cause such serious side effects. Ask your health care team what steps you can take to stay healthier while you're taking corticosteroids.

Your doctor might also know of local support groups in your area. Talking to others who are living with the same illness and challenges can be helpful.

Source: http://www.mayoclinic.com

Risk factors

Risk factors for polymyalgia rheumatica include:

  • Age. Polymyalgia rheumatica affects older adults almost exclusively. It most often occurs between ages 70 and 80.
  • Sex. Women are about two to three times more likely to develop the disorder.
  • Race. Polymyalgia rheumatica is most common among white people whose ancestors were from Scandinavia or northern Europe.

Source: http://www.mayoclinic.com

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