How Do You Know if You Have Polymyalgia

What is polymyalgia rheumatica?

Polymyalgia rheumatica (poly-my-al-ger ru-mah-ticker), or PMR, is a relatively common condition that causes stiffness and pain in muscles. The give-and-take 'poly' means many and the give-and-take 'myalgia' means muscle pain.

It can start at whatsoever historic period from l, but mainly affects people over the age of 70. More than women are affected than men.

Symptoms

Polymyalgia rheumatica can cause pain and stiffness in the shoulders, neck, hips and thighs.

Polymyalgia rheumatica often comes on quickly, perhaps over a week or two. It can start just after a flu-like illness. The stiffness may exist so astringent that dressing, reaching, washing, climbing stairs or even getting out of bed may be difficult.

The symptoms are different from the ache y'all may feel after exercise that your body isn't used to. The pain and stiffness from polymyalgia rheumatica is often widespread, and is worse when resting or after rest. Symptoms can improve with activeness or as the solar day goes on. The pain may also wake you lot at night.

It's besides common to feel unwell or to have a slight fever, and you may lose weight. At times, tiredness can exist overwhelming, this is known equally fatigue. The condition tin also make y'all feel low and anxious, and depressed.

If you have polymyalgia rheumatica, you are at a higher risk of getting a condition chosen giant cell arteritis (GCA). This involves inflammation of the blood vessels called arteries.

This needs urgent treatment as there's a risk of permanent loss of your eyesight or having a stroke with giant cell arteritis.

The symptoms of giant jail cell arteritis are:

severe headaches and pain in the muscles of the head
tenderness at the temples, the soft part of the head at the side of the eyes
pain in the jaw, tongue or side of the face when chewing
hurting or swelling in the scalp
blurred or double vision.

If your doctor suspects giant cell arteritis, yous'll be referred to a specialist and may accept a biopsy of the temporal artery. This is where a small piece of the artery is taken from the head and examined nether a microscope. You'll be given a local anaesthetic to numb the expanse.

Your doctor may start you on a high dose of steroids earlier y'all see a specialist to forbid possible loss of vision.

Diagnosis

There's no specific examination to diagnose polymyalgia rheumatica.

Your doctor will brand a diagnosis after listening to you talk about the history of your symptoms and by carrying out a concrete examination. You'll also have claret tests to check for whatsoever inflammation in your trunk, and to rule out other conditions.

If yous're over fifty and have the following symptoms and signs your GP will probably diagnose polymyalgia rheumatica, and start treatment directly away:

new shoulder, neck, hip or thigh pain on both sides of the body, which has been present for at least two weeks
pain and potent muscles in the shoulders, hips or thighs in the mornings that lasts at least 30 minutes
high levels of inflammation measured by blood tests
no evidence of rheumatoid arthritis, such as swollen joints, or positive blood tests.

You may be referred to a rheumatologist if at that place'south any doubt about the diagnosis or if in that location are complicating factors. This could exist if the symptoms don't meliorate with steroid treatment or if you take side furnishings from the treatment.

The presence of inflammation alone won't confirm the diagnosis of polymyalgia rheumatica. Inflammation is a feature of many other weather, including infections and rheumatoid arthritis, then your physician may do some tests to wait for signs of other weather. Y'all may need to take tests such equally x-rays or ultrasound scans.

In that location are other forms of imaging scans that may occasionally exist requested by a rheumatologist to rule out other weather. These include magnetic resonance imaging (MRI) and positron emission tomography (PET) scans.

A status chosen anaemia (an-ee-me-a), which is a lack of blood-red blood cells that carry oxygen effectually the torso, is quite mutual in polymyalgia rheumatica. Your md may test for this. However, anaemia tin also occur in other weather.

Treatments

Guidelines setting out the best treatment and care for people with polymyalgia rheumatica state there should be shared decision making between a patient and their healthcare professionals.

If you have this status, yous should have a treatment plan tailored to you, that includes:

initial dose of steroids and a schedule for when this dose will ideally be reduced and by how much, if your condition remains under control
admission to education focusing on the impact of the status.

You may exist given a contact phone number or helpline number for admission to your doctor or nurses, if yous have concerns about any changes in your condition such as flares or side effects to drugs.

Steroids

Steroid handling is normally very effective to treat polymyalgia rheumatica.

Steroids piece of work by reducing inflammation. They can't cure your condition, but the symptoms will improve significantly within 2 weeks once steroid treatment is started. Normally, steroid treatment for polymyalgia rheumatica volition be taken as tablets.

Your symptoms may almost disappear after iv weeks of steroid treatment. However, treatment ordinarily needs to keep for up to two years, or occasionally longer, to terminate the symptoms returning.

The steroid tablet nearly frequently prescribed is called prednisolone.

Potential side effects can include weight gain and the condition osteoporosis, which can cause people's basic to become thinner and more fragile, and therefore may fracture more easily.

There are groups of people who could be at an increased risk of side furnishings, including those who take:

diabetes
high blood pressure
a recent fracture
a peptic ulcer
a cataract
glaucoma.

If you're in one of these groups, your medico volition talk to you most drugs that may exist prescribed alongside steroids to reduce whatever risks.

After two to 4 weeks, your md will gradually reduce the dose of steroids.

The reduction will be made in stages depending mainly on your symptoms but helped past carrying out repeated claret tests to wait for inflammation.

If symptoms render when the dose is reduced, your dr. may have to increase the dose for a brusk fourth dimension, possibly several weeks, and and then endeavour to reduce it once more.

You shouldn't cease taking your steroid tablets suddenly or alter the dose unless advised by your md, even if your symptoms accept completely cleared up. This is because your torso stops producing its own steroids, chosen cortisol, while you lot're taking steroid tablets. Your body volition need some time to resume normal production of natural steroids when the medicine is reduced or stopped.

Even when you feel well, your doctor may wish to come across y'all regularly so that y'all tin can be assessed for signs of the status coming dorsum, or side effects from the drugs. Your dr. may want to bank check your general health and check your blood pressure level, blood carbohydrate and cholesterol. You may also exist asked to have a os density (DEXA) scan to check the strength of your bones.

It'due south recommended y'all conduct a steroid carte du jour that shows what dose of tablets you're on and how long you lot've been taking them.

This volition assist if you need to see another physician, for example while you lot're away from home, or another healthcare professional, for example a dentist. Please prove them the card – depending on what additional treatment you need, the steroid dose may need to exist adjusted.

Steroid cards are available from most pharmacies.

Other treatments

Prevention of osteoporosis

Similar all medicines, steroids can have side effects. One of the side effects of steroids is osteoporosis, which can cause bones to go thinner and so fracture.

The nationally recommended treatment for this is medicine chosen bisphosphonates (biss-foss-fo-nates). These are a group of drugs that tin slow downward or prevent bone loss. Yous can ask your md most treatment with bisphosphonates. Examples include alendronate and risedronate.

Hurting relief

Painkillers, such as paracetamol, or short courses of not-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help ease pain and stiffness. They can exist taken at the same fourth dimension equally steroid tablets.

Affliction-modifying anti-rheumatic drugs (DMARDs)

At that place may exist some situations where your doctor will want to prescribe a type of drug called a affliction-modifying anti-rheumatic drug (DMARD), alongside steroids.

These drugs piece of work by reducing inflammation that is causing symptoms such as pain and stiffness.

DMARDs permit a lower dose of steroid to exist used.

These drugs could exist prescribed if:

your symptoms don't improve with steroids
y'all have unusual symptoms
it's difficult to reduce the dose of steroids
you get frequent flare-ups of your condition, where your symptoms rapidly get worse.

You may need to run into a specialist to be prescribed a DMARD.

The specialist may make up one's mind to prescribe a DMARD alongside steroid tablets, which may assistance to reduce the inflammation and lower the steroid dose. An example is methotrexate.

If you're taking a DMARD it'south important to have regular bank check-ups, claret force per unit area checks and blood tests to check for potential side effects.

Living with polymyalgia rheumatica

Steroid treatment is commonly very effective at treating polymyalgia rheumatica. All the same, because it can increase your chance of getting osteoporosis, it's important to think most other adventure factors associated with this condition.

Smoking or drinking a lot of alcohol will increase your risk of developing osteoporosis.

Ensuring you go enough calcium and vitamin D, and that you do some weight-begetting exercise will reduce the risk of getting osteoporosis.

Keeping active

If y'all have polymyalgia rheumatica, yous'll need to observe the right balance between rest and activity. Too much exercise is likely to make your symptoms worse, but activity usually helps to ease hurting and stiffness in the muscles of the shoulders, hips and thighs.

Physiotherapy, including range of motion exercises for the shoulders, tin can help to reduce pain and maintain mobility.

Weight-begetting exercise is good for maintaining bone strength and reducing the take chances of osteoporosis.

Weight-begetting exercise is anything like jogging, walking, tennis, dancing or lifting weights, where some strength or the weight of the body is impacted on basic during the exercise. This is in contrast to pond, for example, where the h2o supports the weight of the body. Walking is unremarkably the most suitable weight-bearing exercise for people with polymyalgia rheumatica.

Sitting for any length of time may crusade stiffness, making activities such every bit driving more hard. Cease from fourth dimension to time on a long journey to stretch your shoulders, arms and legs.

Uncomplicated measures such as a hot bath or shower tin help to ease pain and stiffness, either offset thing in the forenoon or after exercise.

Diet and nutrition

Steroid treatment reduces the amount of calcium in the body.

If you're on steroid treatment, it'south recommended you aim for a daily intake of 700–1200 mg of calcium.

A pint of milk a twenty-four hours, together with a reasonable amount of other foods that comprise calcium, should be plenty.

Advisable calcium content of some common foods

Food	Calcium content
115 thou (4 oz) whitebait (fried in flour)	980 mg
60 g (two oz) sardines (including bones)	260 mg
0.2 litre (1/3 pint) semi-skimmed milk	230 mg
0.2 litre (1/3 pint) whole milk	220 mg
3 large slices chocolate-brown or white bread	215 mg
125 g (four one/2 oz) low-fat yogurt	205 mg
30 g (1 oz) difficult cheese	190 mg
0.2 litre (one/3 pint) calcium-enriched soya milk	180 mg
125 g (iv 1/two oz) calcium-enriched soya yogurt	150 mg
115 g (4 oz) cottage cheese	145 mg
115 g (iv oz) baked beans	60 mg
115 yard (4 oz) boiled cabbage	40 mg

Notation: measures shown in ounces or pints are gauge conversions only.

Vitamin D

Vitamin D is needed to assist the body blot calcium.

The best source of vitamin D is sunlight on bare pare. However, sunshine in the Great britain isn't expert enough all year round to guarantee we become the vitamin D needed.

Because of this, and because it's an of import food, it's recommended that nosotros all take vitamin D supplements in the autumn and winter months. These can exist bought from supermarkets and health food shops. Yous can too discuss this with a chemist.

There are some at risk groups who are advised to accept vitamin D supplements all year circular, including:

people who are housebound and therefore don't go out in the sunshine often enough
people who article of clothing clothes that cover their whole body, limiting the corporeality of sunshine on their skin
people with night skin, because night peel is not equally good as arresting vitamin D from sunlight, compared to pale pare.

Dorothy's story

I was 57 when I developed polymyalgia rheumatica and giant cell arteritis. I was head of news and current affairs at Aqueduct Four television and a single parent of a child of 12.

Information technology began with a very sore neck. I tried massage, but it didn't work. And so my shoulders started to ache.

On a few mornings, when I woke up, I plant it difficult to move my arms, though my hands moved hands. The trouble would wear off quickly, and I would forget about information technology.

And so one forenoon I woke up and my arms wouldn't motility at all for 20 minutes. Although I was immature to get the condition, I knew I had polymyalgia rheumatica, equally my mother had it.

It makes y'all suddenly feel like an old lady as you lot can't move properly.

I was given a blood test to check inflammation levels and was put onto steroid tablets. Unfortunately, I wasn't put on a high plenty dose and the aches, pains and weakness got worse.

One night I was and then sick and tired I couldn't even open my eyes. A few nights I had to tell my daughter to have toast for dinner because I couldn't move.

My daughter was very upset and frightened. I would take to become to bed as shortly as I got home. Sometimes during the day, I would get into my motorcar in the car park and sleep. When I was put on the correct dose of steroids I felt OK, merely did cutting dorsum my social life a lot.

Eventually, I developed a terrible headache and my jaw became very stiff. I knew at once this was giant cell arteritis. I had to immediately accept a very large dose of steroids to foreclose sight loss, which is a very real risk with GCA.

For 2-and-a-half years I had to have steroids then I was moved onto methotrexate for a year. I put on weight and my face up took on a moon shape. I became tired much more easily.

Early on I joined the patient group PMRGCAuk. I found it really helpful to meet other people with the condition and swap experiences and ideas.

Afterward iii-and-a-half years, the condition went away. I came off the drugs. My weight went downward and my face up returned to its normal shape. As I had taken that high dose of steroids when I developed GCA, my sight is fine.

As head of news and current affairs, I take ultimate responsibleness for Aqueduct Iv News, Dispatches, Unreported Earth and all other news and current affairs programming. I generally work at least 60 hours a week commissioning programmes, watching films and dealing with a wide range of programmes.

I would say that I should have taken fourth dimension off piece of work and that I had to learn to await less of myself and to tell others I had a debilitating illness, then they should wait less of me.

gallihinface1980.blogspot.com

Source: https://www.versusarthritis.org/about-arthritis/conditions/polymyalgia-rheumatica-pmr/