Polymyalgia rheumatica is a chronic inflammatory condition that usually implies pain and stiffness in the neck, shoulders, upper arms, lower back and hips. The pain is more prominent in the morning and usually decreases throughout the day. It appears, on average, around the age of 70.

Causes

The exact cause is unknown, although genetics and environmental aspects are believed to play a definite role in the development of this condition

The observation that new cases are diagnosed seasonally has led to the assumption that polymyalgia may be triggered by certain viruses such as: the adenovirus (responsible for respiratory infections), the human parvovirus B19 and the human parainfluenza virus (symptoms resemble the common cold)

Symptoms and signs

 

The onset is very sudden – waking up one morning experiencing pain

Pain and aches in the shoulders (usually the first symptom)

Pain and stiffness in the neck, upper arms, lower back, hips and/or thighs

Most prominent in the morning or after a long period of inactivity

Limited range of motion due to the affected areas of the body

General state of ill-being, overall weakness sensation

Fatigue

Loss of appetite

Unintended weight loss

A mild feverish state

Depression

Anemia

Advice

 

The diagnosis is set by rheumatologists

 

Certain blood tests are required to determine inflammatory processes in the body: erythrocyte sedimentation rate (or “sed rate”), C-reactive protein (or CRP) – in the case of Polymyalgia rheumatic, the results of these tests come out very elevated

 

In a first phase of diagnosis, a trial dose of corticosteroids will be administered

 

Corticosteroid treatment often has a radical effect – patients are relieved of pain and stiffness after the first doses

 

After the unpleasant symptoms are under control, the doctor will start slowly decreasing the corticosteroid medication doses until the lowest and most efficient dose is reached

 

Treatment is complete usually within a year, but in some cases can last up to 2 or 3 years

 

In some cases the symptoms can recur after a period of time, but that does not mean that they have become resistant to treatment

 

The corticosteroid treatment is highly efficient but requires a careful monitoring because of its side effects

 

The patient and his doctor must pay attention to: blood pressure, blood sugar, weight gain, sleep disorders, osteoporosis, cataracts and thinning of the skin

 

In cases of advanced age, osteoporosis medication may be required along corticosteroid treatment

 

A healthy diet and easy exercise are recommended in order to ease side effects of the corticosteroid treatment

MISCONCEPTIONS
  •  

    Polymyalgia rheumatica is a form of fibromyalgia (long-term condition that causes widespread pain)

     

    Polymyalgia develops slowly in time and is only diagnosed at an older age

     

    The diagnosis of this condition is based on X-rays of the patient’s joints

     

    Polymyalgia rheumatica can affect anyone, at any age

Statistics

The condition is more common in Northern Europeans

 

It usually affects twice as many women than it does men

 

It is more frequent in white people than in other ethnic groups

 

Average annual incidence in the USA: 52.5 cases per 100,000 persons (over 50 years old)

 

An estimated 711,100 Americans suffer from polymyalgia rheumatica

 

In Europe, the frequency of this condition decreases from North to South (example: Italy: 12.7 cases per 100,000 persons over 50 years old)

Did you know?

 

Nonsteroidal anti-inflammatory medication (NSAIDs), such as ibuprofen have no effect in the treatment of polymyalgia rheumatica

 

Polymyalgia rheumatica is usually associated with another inflammatory disorder – Giant Cell Arteritis – which causes headaches and jaw pain, and also vision difficulties