A health condition that causes aches, pain, and stiffness in large groups of muscles (such as the hips and shoulders) is called polymyalgia rheumatica. While the symptoms can worsen in the morning, they usually disappear with activity. Nowadays, researchers do not know why this condition occurs. That’s why it cannot be cured, but with treatment, you can ease the symptoms.
Moreover, this disorder mostly affects people over 50 years old. Primarily, this condition affects the neck, shoulders, and hips, but can also cause symptoms in the upper arms, thighs, and back. In most cases, pain occurs on both sides of the body.
In general, this condition affects about 50 in every 100,000 people in the U.S per year. Usually, it affects people over the age of 50, but the risk of developing it increases significantly after the age of 70.
Symptoms
One of the most common symptoms of this condition is sudden pain and stiffness around large joints (especially around the hips and shoulders). Sometimes, people with polymyalgia rheumatica can feel discomfort in the arms, back, and buttocks. Moreover, you may have trouble performing ordinary tasks, including getting dressed or brushing your hair. However, this condition can also cause other symptoms. These include:
- Muscle stiffness that lasts about 30 minutes in the morning
- Weakness
- Extreme tiredness (fatigue)
- Appetite changes
- Weight loss
- Swelling in the wrists and hands
- Fever
According to some research, approximately 10% to 20% of people with polymyalgia rheumatica also have other disorders, such as giant cell arteritis (also known as temporal arteritis). It is a form of vasculitis that causes inflammation of large blood vessels (such as the aorta) and temporal arteries. On the other hand, about 40% to 60% of people with temporal arteritis can develop polymyalgia rheumatica.
What Are The Triggers and Risk Factors of Polymyalgia Rheumatica?
While healthcare professionals cannot find the exact cause of this condition, they believe the following factors could play a role. Examples include:
- Genetics
- Aging – There is an increased risk of developing this condition in people over 50 years old. Furthermore, in people over 70 years old, the risk of developing it increases even more.
- Bursitis (inflamed sacs in the hips or shoulders)
- Autoimmune disorders – These are conditions in which the immune system produces and releases antibodies that mistakenly attack healthy cells in the body.
- Environmental factors (such as infections or prolonged exposure to chemicals)
In addition, some research has shown that certain people are more prone to polymyalgia rheumatica. These include:
- Sex – Females are more likely to develop this condition than men.
- Ethnic and racial background – Caucasian people (especially people of Northern European ancestry) are more likely to have this condition than other ethnic or racial groups.
What Are The Long-term Effects of Polymyalgia Rheumatica?
People who develop this condition and leave it untreated can experience some complications. Check below some of them:
- Problems with mobility, including difficulty dressing, bathing, brushing the hair, and other activities.
- Giant cell arteritis (GCA) – This is a serious condition often linked with polymyalgia rheumatica. Generally, GCA increases the risk of vision problems, stroke, severe headaches, and other health problems.
- Increased risk of infections
- Osteoporosis – This is a condition in which the bones become weakened, making the affected person more prone to fractures.
- Cardiovascular disease (such as myocardial infarction, strokes, and blood clots)
- Muscle weakness
- Anemia (low red blood cell count)
- Weight gain
- Malaise
- Mental health issues (including anxiety and depression)
The previous list does not contain all possible complications of polymyalgia rheumatica. However, you can talk with your physician about measures to reduce the risk or even prevent them. In addition, there is no way to prevent this condition because experts do not fully understand why it happens.
Diagnosis
Usually, it is quite challenging to diagnose this condition because the symptoms are similar to other health conditions. These include rheumatoid arthritis, spondyloarthritis, pseudogout, myositis, and other connective tissue disorders. To confirm this condition, doctors will rule out the previous disorders through performing blood tests, including the following types. For example:
- Complete blood count (CBC)
- Creatine kinase
- Thyroid-stimulating hormone (TSH)
- Erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
Sometimes, doctors can diagnose polymyalgia rheumatica based on your response to Corticosteroids (steroids). In most cases, people begin to feel better within several days with Prednisone.
Treatment
Usually, doctors begin the treatment of this disorder with a low-dose of Corticosteroids. In most cases, they recommend 10 to 15 mg of Prednisone per day, which effectively relieves the symptoms (such as muscle stiffness). If this medicine improves your disease, doctors often reduce the dose over time. In some cases, people should take a low-dose of Prednisone for a long period to prevent flares. Furthermore, doctors can also prescribe other medicines to treat complications caused by this medicine or condition. You may get treatment for the following health problems. For example:
- Cardiovascular disease
- Diabetes
- Skin atrophy (thinning of the skin)
- Hypertension (high blood pressure)
- Weight gain
- Osteoporosis (brittle bones)
- Eye disorders (such as cataracts)
However, experts have studied other medicines for the treatment of this disorder. These include immunosuppressants (such as Methotrexate) and a biologic medicine (Tocilizumab) that is primarily used to treat giant cell arteritis and rheumatoid arthritis. Another part of the polymyalgia rheumatica treatment is rest and exercise. Doctors often recommend, along with medicines, the following type so exercise to improve muscle function. For example, riding a stationary bike, swimming, or walking. In more severe cases, doctors may recommend physical therapy to ease the symptoms and improve mobility.
Frequently Asked Questions
When should I see my healthcare provider?
Corticosteroids can cause some adverse reactions, especially if they are used for long periods. You should see your doctor if any of the following symptoms occur. For example:
- Sleeplessness
- Bruising
- Cataracts
- Osteoporosis
- Hypertension
- Weight gain
Sometimes, giant cell arteritis may overlap with polymyalgia rheumatica and cause additional symptoms. These include:
- Fever
- Tenderness around the scalp
- Jaw pain
- Vision problems
- Headaches
Is polymyalgia rheumatica an autoimmune disease?
Yes, this disorder is considered an autoimmune disease, but the exact cause is not fully understood by experts. According to some research, this disorder is an inflammatory condition in which the immune system affects large groups of muscles (such as those of the shoulders and hips).
What illness can be mistaken for polymyalgia?
There are some disorders that can be mistaken for polymyalgia rheumatica. These include:
- Fibromyalgia
- Rheumatoid arthritis
- Lupus
- Polymyositis
- Lyme disease
The previous list does not contain all possible conditions that can be mistaken for polymyalgia rheumatica. If you have additional questions, ask your healthcare provider.
