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Polymyalgia Rheumatica | Senior’s Worst Enemy

Polymyalgia Rheumatica


Pain and stiffness in the body might be something that comes with getting old. But what if that’s not all true? There are such disorders that cause severe pain in muscles in people above the age of 50. One of these disorders is polymyalgia rheumatica which is claimed to be the senior’s worst enemy.

What is Polymyalgia Rheumatica?

Polymyalgia rheumatica (poly-my-al-ger-ru-mah-ticker), or PMR, is a widespread condition in adults. It causes pain and stiffness in both sides of the body, such as the neck, arms, lower back, and thighs. The name of this disease itself describes the condition very well. The word “poly” translates as “many,” and “myalgia” means muscle pain.

It can affect people above 50, especially Caucasians. Polymyalgia rheumatica can be found more in white people than non-whites. Symptoms of PMR tend to develop quickly and get severe in the morning. 

The achiness lessens as the day passes. However, it can rise again because of inactivity, such as long car rides, where muscles are not moving, which can provoke stiffness again. Sometimes, body stiffness is so bad that it can further cause restless sleep and trouble in even getting dressed by yourself in the morning. 

Symptoms of Polymyalgia Rheumatica:

Polymyalgia rheumatica commonly affects the arms, shoulder, neck, and hips. If it is not treated in time, the disease can inflict more damage to body muscles. 

Some other commonly found symptoms of polymyalgia rheumatica includes:

  • Anemia
  • Mild fever
  • Depression 
  • Tiredness
  • Malaise 
  • Loss of appetite
  • Sudden weight loss

People diagnosed with polymyalgia rheumatica also tend to have temporal arteries – also known as giant cell arteritis. People with temporal arteries can feel inflammation of arms and neck blood vessels, headaches, low vision, and jaw pain. 

What is Giant Cell Arteritis?

In case you have Polymyalgia rheumatica, there is a higher chance that you get diagnosed with giant cell arteritis (GCA). A very critical situation, if left untreated, can further increase the risk of stroke or losing eyesight permanently. 

Common symptoms of giant cell arteritis are:

  • Blurred vision 
  • Pain in muscles, jaw, and tongue
  • Headaches
  • Tenderness at the temples 
  • Swelling and pain in the scalp

If you get diagnosed with GCA, you will be referred to a specialist and receive a temporal artery biopsy. 

What Causes Polymyalgia Rheumatica?

The exact cause of polymyalgia rheumatica is unspecified. However, certain factors that can be a cause of developing PMR are:

  1. Genetics: Certain genes play a role in causing the PMR in senior citizens. In case of similar symptoms, it would help if you got your genetic testing done to avoid complications.
  2. Environmental Exposure: The environment triggers such conditions. Some new cases of polymyalgia rheumatica are seasonal and are caused by a particular virus. However, no such studies are found about a specific virus or infection that causes polymyalgia rheumatica.

How to Diagnose Polymyalgia Rheumatica?

Till now, there is no specific test or method to diagnose polymyalgia rheumatica. You need to tell your doctor about the history of your symptoms for him to listen and analyze it. Your doctor can also assess some blood tests to check the inflammation rate in your body. 

If you are above 50 or in your 70’s, there is a higher chance that you will get diagnosed with it if you have experienced most of the symptoms. And in case you have polymyalgia rheumatica, your doctor will start the treatment right away to avoid any complications. 

Some of the conditions from which your doctor is able to diagnose:

  • No swollen joints.
  • No presence of rheumatoid arthritis.
  • High inflammation found during blood tests.
  • Pain in shoulder, thigh on both sides for more than two weeks.
  • Severe pain and stiffness in muscles during the morning that lasts up to half an hour.

If there is a complication in diagnoses or side effects from the treatment, your general physician might refer you to a rheumatologist. However, the high inflammation is not the final verdict of having polymyalgia rheumatica. 

Other conditions can happen because of increased inflammation, such as rheumatoid arthritis and infections. Your doctor may run some further tests like X Rays or ultrasound to assess the condition. Some test run to measure your C-reactive protein level and  erythrocyte sedimentation rate (ESR)

Rheumatologists perform imaging scans such as positron emission tomography (PET) and magnetic resonance imaging (MRI) to rule out other factors. One of the common symptoms found in polymyalgia rheumatica patients is anemia ( an-ee-me-a). Anemia is caused by a lack of red blood cells responsible for carrying oxygen around the body. 

Effective Treatments For Polymyalgia Rheumatica 

Your doctor will start the treatment right after the diagnosis. There should be a tailored treatment for you 

  • Initially, a dose of steroids 
  • When to reduce the quantity and how much
  • Further blood tests to keep in check the cholesterol level
  • Annually eye check-up exams
  • Some other tests to monitor the condition, such as bone density tests 

Steroid treatment is proven to be very effective for PMR patients. Prednisolone is the most prescribed steroid tablet. This medication can create side effects in diabetic patients and people with high blood pressure.

Your doctor put you on the trail of 10-15 milligrams low-dose of corticosteroids. If you have PMR, the dose of prednisone will quickly cure the stiffness. The response of this medicine is rather dramatic as some patients show results only after the first dose. 

The process of improvement is slow, but if symptoms don’t go away in 2-3 weeks of treatment, your doctor might consider other medication. 

The objective is to give you the lowest dose to keep your health comfortable. If your condition is under control after some weeks, your doctor will reduce the quantity of corticosteroid medicine. 

Some people stop taking medication after a year. Others need to take it for 2-3 years to keep the stiffness and pain under control. 

Using these medications in the long run can lead to health complications like:

Anti-inflammatory nonsteroidal (NSAIDs): Naproxen and Ibuprofen are not affected for PMR treatments.

If your condition doesn’t get better after weeks of treatment, your doctor needs to look for another rheumatic disorder: osteoporosis and rheumatic fever. 

Risk Factors of Polymyalgia Rheumatica

The risks of polymyalgia rheumatica are:

Age: Polymyalgia rheumatica exclusively affects senior citizens. Most occur between the age group 60 to 80 years old.

Gender: Women are two to three times more likely to get the PMR

Race: PMR disorder is most common in white people with ancestors from northern Europe and the Scandinavian.

Complications of Having Polymyalgia Rheumatica

Living with polymyalgia rheumatica can cause complications in the day-to-day routine. The situation gets worse if PMR is not treated on time. The stiffness and pain caused by polymyalgia rheumatica severely affect your mobility. 

Simple tasks such as bathing, changing clothes or shoes, and combing your hair gets difficult. People with PMR also develop peripheral artery disease. Others face several joint problems and conditions, such as frozen shoulders. 

The Best Cure: Keeping Muscles Active

There is no specific cure for polymyalgia rheumatica, but the stiffness goes away with proper treatment recommended by your doctor. The right balance between activity and rest helps older people get at a comfortable condition during polymyalgia rheumatica. 

You need to ensure you get enough vitamin D and Calcium. Avoid heavy or too much exercise. Instead, try low-impact exercises such as walking and stretching as they usually help lower the stiffness in muscle and ease the pain. Simple activities such as a warm bath or shower also help to ease the pain. 

Taking steroids for PMR treatment reduces the calcium in the body. It’s recommended for people on steroid treatment to take 700-1200 mg calcium. 

People with polymyalgia rheumatica, who are housebound and rarely go out, don’t get enough sunshine. For such patients, it is recommended to take vitamin D supplements regularly to help absorb calcium in the body.

FAQs: Polymyalgia Rheumatica

1- What triggers polymyalgia rheumatica?

The exact cause of polymyalgia rheumatica is unspecified. However, factors such as genetic predisposition such as familial tendencies, and immunological factors have been related to medical literature. PMR is similar to an inflammatory disorder, giant cell arteritis. 

2- Does polymyalgia rheumatica ever go away?

Alongside proper treatment, self-care helps to lessen the symptoms within days or weeks. Without treatment, it might take years for the symptoms to go away. Self-care includes nutrition pack meals, low impact exercise, light activities followed by proper rest. Finally, and most importantly, use appropriate doctor’s recommended medications and treatments. 

3- How is polymyalgia rheumatica diagnosed?

There is no particular test for polymyalgia rheumatica. Yet, a series of blood tests such as C-reactive protein and Erythrocyte sedimentation rate is prescribed mainly by health advisors. 

4- What does polymyalgia pain feel like?

Polymyalgia rheumatica (PMR) pain rises in the shoulder, arms, and thighs, especially in the morning. The stiffness and pain increase quickly over a few days. Both sides of the body experience severe pain that makes you unable to move your body for the day-to-day routine. 

5- What happens if PMR is left untreated?

If it is not treated, then the condition of PMR patients gets worse with time. PMR directly affects mobility. Your whole body starts getting effective because the muscle making the stiffness makes it difficult to stand up from a chair or getting in or out of a car.

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