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THE DEFINITIVE GUIDE FOR THE TREATMENT OF POLYMYALGIA RHEUMATICA


WHAT IS POLYMYALGIA RHEUMATICA?

Polymyalgia rheumatica is a disorder typically seen in older adults that causes widespread pain and stiffness in various muscles of their body, especially around the shoulders, neck, and hips.

The word ‘poly’ means many and the word ‘myalgia’ means muscle pain.

WHAT ARE THE RISK FACTORS FOR POLYMYALGIA RHEUMATICA?

  • Age: average age when symptoms start is 70yrs.
  • Sex: disease affects women more often than men. 
  • Race: more frequent in whites than non-whites, but people of all races can get it. 
  • Smoking or drinking alcohol will increase your risk of developing this disease.

WHAT ARE THE COMPLICATIONS OF POLYMYALGIA RHEUMATICA?

Polymyalgia rheumatica symptoms can interfere with day-to-day activities, especially if the condition goes untreated. 

Without appropriate treatment, the pain and stiffness can severely reduce mobility. You may eventually become unable to complete simple tasks on your own, such as bathing, getting dressed, combing your hair, climbing stairs, etc. Some people also experience a temporary loss of joint function. 

Some people with this disease can develop a potentially dangerous condition called giant cell arteritis (or temporal arteritis involves inflammation of the blood vessels called arteries). 

It can cause headaches(on the side of the head), scalp tenderness, vision changes or jaw pain when eating.

People with polymyalgia rheumatica sometimes can also develop peripheral artery disease. This condition impairs blood circulation causing leg pain and ulcers.

WHAT ARE THE SYMPTOMS OF POLYMYALGIA RHEUMATICA?

Symptoms make start slowly or suddenly.

Stiffness is usually worse in the morning and during long periods of inactivity but improves with activity as the day goes on. It can also lead to a lack of use of some body parts, which could result in their weakness. 

Patients can also complain of weakness, fever, poor appetite, or weight loss.

WHAT ARE THE CAUSES OF POLYMYALGIA RHEUMATICA?

It is an autoimmune disease in which the body’s own immune system starts attacking the connective tissues. The exact cause of polymyalgia rheumatica isn’t known.

Environmental factors may also play a role in the development of the disorder as new cases of polymyalgia rheumatica are often diagnosed in cycles and usually occur seasonally. This suggests that there may be an environmental trigger, such as a viral infection, that causes the condition. The rapid onset of symptoms also suggests that polymyalgia rheumatica may be caused by an infection.

DIAGNOSIS OF POLYMYALGIA RHEUMATICA

To make an accurate diagnosis, the doctor performs a physical examination and runs several tests to check for inflammation and blood abnormalities.

The symptoms of polymyalgia rheumatica can be similar to those of other inflammatory conditions, including lupus and arthritis. 

So blood tests will be done to check inflammation levels and to rule out other conditions. 

Blood tests may include:

  • Anti-cyclic citrullinated peptide (anti-CCP): to rule out rheumatoid arthritis
  • Antinuclear antibody (ANA): to rule out SLE
  • Complete blood count (CBC)
  • C-reactive protein (CRP): used to check the levels of inflammation in your body.
  • Erythrocyte sedimentation rate (ESR): is used to check the levels of inflammation in your body.
  • Rheumatoid factor (RF): to rule out rheumatoid arthritis.
  • X-rays and ultrasound scans may also be used to look at the condition of your bones and joints.

TREATMENT OF POLYMYALGIA RHEUMATICA

Conventional treatment includes anti-inflammatory medication, steroids, and exercise. The side effects can include weight gain and osteoporosis, which can cause people’s bones to become thinner and more fragile, and hence may fracture more easily.

MANAGEMENT OF POLYMYALGIA RHEUMATICA

Both exercise and rest play important roles in treatment. Regular exercise is essential for maintaining joint flexibility, muscle strength, and function.

You can try walking or riding a stationary bicycle. Too much exercise is likely to make your symptoms worse, but activity usually helps to ease pain and stiffness in the muscles. Rest is also necessary to give the body time to recover from exercise and other activities.

Weight-bearing exercises are good for maintaining bone strength and reducing the risk of osteoporosis like jogging, walking, tennis, dancing, or lifting weights, where some force or the weight of the body is impacted on bones during the exercise.

HOMOEOPATHIC MANAGEMENT OF POLYMYALGIA RHEUMATICA

Given that polymyalgia rheumatica is a self-limiting condition, lasting from one to five years, homeopathic medicines can be the first choice for the management of this disease as they give relief without any side effects. 

Some of the common homeopathic medicines that can be used in this disease are- Rhus tox, kali bichrom, ledum pal, ruta, phytolacca, sanguinaria, etc.

In each case, suitable homeopathic medicine is selected depending upon characteristic symptoms found in the patient and it should never be taken without consultation of a registered homeopathic doctor.

DO’S AND DON’TS

DO’S

  • Take proper nutrition, 
  • balance your activity and rest 
  • A hot bath or shower can help to ease pain and stiffness.
  • Staying hydrated is important for combating inflammation

DON’TS

  • Limit your milk, caffeine, sugar, and alcohol intake.
  • Avoid stress.

 

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