Polymyalgia rheumatica

Description

Polymyalgia rheumatica is an inflammatory disease. Causes joint and muscle pain and stiffness, primarily on the shoulders and the hips. The symptoms of polymyalgia rheumatica (pol-e-my-AL-khuh rue-MAT-ih-kuh) may begin quickly or over several days to weeks. The symptoms are more often worse in the morning.

Most of the people who receive the polymyalgia rheumatica are older than 65 years. It rarely affects people under the age of 50.

This condition is related with the yearof your inflammatory condition called giant cell arteritis. Giant cell arteritis can cause headaches, vision problems, pain in the jaw, and scalp tenderness. Some people have polymyalgia rheumatica and giant cell arteritis.

Symptoms

The symptoms during rheumatica more often affect both sides of the body. These could include:

  • Discomfort or pain in the shoulders.
  • Discomfort or pain in the neck, upper arms, buttocks, hips, or thighs.
  • The stiffness in the affected areas, mainly in the morning or after not being active for a time.
  • Less range of motion in the affected areas.
  • Pain or stiffness in your wrists, elbows or knees.

Other symptoms may include:

  • Mild fever.
  • Fatigue.
  • A feeling of not being so, it is called discomfort.
  • Not wanting to eat.
  • Weight loss that happens without trying.
  • Be bluesssed.

When to see a doctor

Consult your health care professional if you have pain or stiffness that:

  • It is new.
  • Prevent you from sleeping well.
  • Makes it difficult to perform daily activities, such as dressing.

Causes

The experts don't know the cause of that during rheumatic. But the genes may be part of the cause. Certain genes and the changes in the genes can increase the risk of polymyalgia rheumatica.

Researchers are studying other causes of the disease.

Giant cell arteritis

Polymyalgia rheumatica and the other condition known as giant cell arteritis are the same in many aspects. Many people who have one of these conditions also have symptoms of the other.

Giant cell arteritis causes swelling and irritation, also called inflammation of the lining of the blood vessels called arteries. This of inflammation often affects the arteries in the temples. But it can also affect other large and medium-sized vessels, such as those for the heart.

The symptoms include headaches, jaw pain, difficulty to see the scalp, and tenderness. Sometimes, fever and loss of weight may be the first symptoms. If not treated, polymyalgia rheumatica can cause a stroke or blindness.

Risk factors

Risk factors for polymyalgia rheumatica include:

  • Advanced age. Polymyalgia rheumatica affects mainly older adults. This most often occurs between ages 70's and 80's.
  • Be assigned to women in childbirth. The people assigned female at birth is around 2 to 3 times more likely to contract the disease than are people assigned male at birth.
  • The white race. Polymyalgia rheumatica is more common among white people of Scandinavia or to the north of Europe.

Complications

The symptoms of polymyalgia rheumatica can make it difficult to perform daily activities, such as:

  • Get out of bed, getting out of a chair or out of a car.
  • Combing the hair in the bathroom.
  • Dress.

These complications can affect your health, social life, physical activity, sleep and well-being.

During the rheumatica

Diagnosis

A physical examination, and laboratory tests can help your healthcare provider find the cause of your pain and stiffness. The test may include-checking the joints and the nervous system, called a neurological examination. During the test, the health professional could gently move their head and limbs to check your range of motion.

Its diagnosis may change during the treatment. Some people who are diagnosed with polymyalgia rheumatica are later diagnosed with rheumatoid arthritis and giant cell arteritis.

The tests you may have include:

  • Blood tests. In addition to the verification of complete blood counts, your health care professional sees two laboratory tests to detect signs of irritation and swelling, called inflammation. These tests are the erythrocyte sedimentation rate, also called a sedimentation rate and C-reactive protein. Not everyone with the condition that has high levels of these proteins in the blood, but most do.
  • Imaging tests. An ultrasound can tell if you have an inflammation of the joints and soft tissues and may help in the diagnosis of polymyalgia rheumatica. Some peopleand have a magnetic resonance imaging or a PET scan to look for other causes of pain in the joints.

Looking for giant cell arteritis

Your health care professional watches for the symptoms that could mean the onset of giant cell arteritis. Talk with your health care professional immediately thatf has any of the following:

  • New headaches or headaches that will not go away.
  • Jaw pain or tenderness.
  • Blurred vision, double vision or loss of vision.
  • Tender scalp.

To confirm a diagnosis of giant cell arteritis, you may have an ultrasound, or a biopsy of an artery in one of your temples. A biopsy involves removing a small sample of the artery to the study under a microscope. The biopsy is performed with a local anesthetic in the area where the artery is removed.

Treatment

Treatment most often consists of medicines to help relieve your symptoms. It is common to obtain a new condition, called a relapse.

Drugs

  • Corticosteroids.A low dose of an oral corticosteroid, such as prednisone, more often it is a polymyalgia rheumatica. You may feel a quick relief from pain and stiffness in 1 to 3 days. After 2 to 4 weeks of treatment, your health care professional may start to reduce the dose slowly. This depends on your symptoms and the results of the blood tests. Because steroids have side effects, the aim is to have you take the lowest dose that maintains that the symptoms from coming back. Many people with polymyalgia rheumatica will need to have the treatment with corticosteroids for 1 to 2 years or more. You have follow-up visits with your health care team often. This is to see how the treatment is working and to monitor side effects. Prolonged use of corticosteroids may result in serious side effects. These may include weight gain, thinning of the bones, high blood pressure, diabetes and cloudy areas of the eyes that can lead to loss of vision, called cataracts. Your health care team watches for side effects. You might need to change the dose, or take medication to administer corticosteroids side effects of treatment.
  • Calcium and vitamin D. You can take a daily dose of calcium and vitamin D supplements to help prevent loss of bone treatment with corticosteroids. The American College of Rheumatology suggests that supplements of 1,000 to 1,200 milligrams of calcium and 600 to 800 international units of vitamin D for any person who take corticosteroids for three months or more.
  • Methotrexate (Trexall).Guidelines of the American College of Rheumatology and the European League Against Rheumatism suggest the use of methotrexate and corticosteroids in some people. This is to reduce the dose of corticosteroids or for relapses. That takand methotrexate by mouth to reduce the immune response. You can take it early in your treatment. Or you may take it later if symptoms recur or corticosteroids do not work well enough.
  • Sarilumab (Kevzara). The Food and Drug Administration has been approved this drug for people whose symptoms recur. This medication works by blocking a substance in the body that cause inflammation. Take this medication as an injection every two weeks. It can relieve the symptoms with low doses of steroids.

Corticosteroids. A low dose of an oral corticosteroid, such as prednisone, more often it is a polymyalgia rheumatica. You may feel a quick relief from pain and stiffness in 1 to 3 days.

After 2 to 4 weeks of treatment, your health care professional may start to reduce your dose slowly. This depends on your symptoms and the results of the blood tests. Because steroids have side effects, the goal is to have you take the lowest dose that maintains that the symptoms from coming back.

Many people with during rheumatica need to have the treatment with corticosteroids for 1 to 2 years or more. You have follow-up visits with your health care team often. This is to see how the treatment is working and to monitor side effects.

Prolonged use of corticosteroids may result in serious side effects. These may include weight gain, thinning of the bones, high blood pressure, diabetes and cloudy areas of the eyes that can lead to loss of vision, called cataracts.

Your health care team watches for side effects. You might need to change the dose , or take medication to administer corticosteroids side effects of treatment.

Methotrexate (Trexall). Guidelines of the American College of Rheumatology and the European League Against Rheumatism suggest the use of methotrexate and corticosteroids in some people. This is to reduce the dose of corticosteroids or for relapses.

Take methotrexate by mouth to reduce the immune response. You can take it early in your treatment. Or you may take it later if symptoms recur or corticosteroids do not work well enough.

Physical therapy

The majority of people who take corticosteroids for polymyalgia rheumatica return to the level of activity that they had before they have the condition. But if you had to limit your activity for a period of time, physical therapy can help. Talk with your healthhcare team about whether physical therapy is a good choice for you.

Self-care

Health professionals may suggest that nonsteroidal anti-inflammatory medicines you get without a prescription to relieve the symptoms of polymyalgia rheumatica. These include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).

-A healthy life style choices can help manage the side-effects of the treatment with corticosteroids may cause:

  • Eat a healthy diet. They eat mainly fruits, vegetables, whole grains and low-fat protein and dairy products. Limit salt, also called sodium in your diet to prevent the accumulation of liquids and high blood pressure.
  • Exercise often. Talk with your health care team about the exercises to help strengthen bones and muscles.
  • Get enough rest. Polymyalgia rheumatica can cause you to feel tired. Your body needs rest to recover from exercise and daily activities.
  • The use of assistive devices. Think of the use of bags and shopping carts, reaching aids, shower, grab bars, and other devices to help make everyday tasks easier.

Coping and support

Even if you feel better soon after you start treatment, you may be distressed by having to take daily medication that can cause serious side effects. Ask your healthcare team what you can do to stay healthy while taking corticosteroids.

Ask about local support groups in your area. Talk with other people who are living with the same challenges that could be of help.

Preparing for your appointment

It is likely to start by seeing your primary health care provider. Your healthcare provider may send you to a specialist in the muscles and joints conditions, called a rheumatologist.

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do before the appointment.

Make a list of:

  • Your symptoms, including any that may not seem to be linked to the reason for which you scheduled the appointment, and when they began.
  • Key personal information, including major stresses or recent life changes, and the personal and family medical history.
  • Some of the medicines, vitamins, and other supplements that you are taking, including the dosage.
  • Questions to ask your health care team.

Have a family member or friend with you, if you can, to help maintain what you learn.

For polymyalgia rheumatica, questions include:

  • What most likely cause of my symptoms?
  • What are other possible causes of the symptoms?
  • What tests do I need?
  • This is a condition likely to go away or to the last?
  • What treatments are there? What do you suggest?
  • I have other health conditions. How can I best manage them ttogether?
  • Do you have brochures or other printed material I can have? What websites do you suggest?

What to expect from your doctor

Your health care team will probably ask you a series of questions, such as:

  • Where is your pain or stiffness?
  • How would you rate your paon a scale of 1 to 10?
  • Is a worsening of symptoms at certain times of the day or night?
  • How long does the stiffness gone, after you get up in the morning or after a period of not being active?
  • Does the pain or stiffness in the limit of their activities?
  • Has had new or bad headaches, or pain in your jaw?
  • Has your vision changed?
Symptoms and treatment of polymyalgia rheumatica