What Is Polymyalgia Rheumatica?
Polymyalgia rheumatica is an inflammatory disorder that causes pain and stiffness in various parts of the body. Parts of the body commonly affected include the shoulders, neck, arms, thighs, and hips. This disorder is most common in people over the age of 55.
The cause of polymyalgia rheumatica is unknown. However, this condition is two times more likely to occur in women than in men (Mayo Clinic). Additionally, polymyalgia rheumatica is more common in people of Northern European and Scandinavian descent.
Some patients diagnosed with polymyalgia rheumatica are also diagnosed with giant cell arteritis. This disorder causes inflammation of the blood vessels in the scalp, neck, and arms. Giant cell arteritis can cause heart attack, stroke, and sudden blindness.
Symptoms of Polymyalgia Rheumatica
Pain and stiffness in the neck and shoulders are common signs of polymyalgia rheumatica. Pain and stiffness start in these parts of the body and gradually affect other areas. These areas include the hips and thighs.
Other common symptoms of this inflammatory disorder include:
- anemia (low red blood cell count)
- loss of appetite
- unintentional weight loss
- a low-grade fever
- limited range of motion
Tests for Polymyalgia Rheumatica
Polymyalgia rheumatica can mimic other inflammatory conditions, including lupus and arthritis. There is no specific laboratory test to diagnose this disorder. However, your doctor will do a physical exam and run several tests to check for inflammation and blood abnormalities.
Your doctor may move your neck, arms, and legs to check your range of motion. He or she may also order a blood test to see if you have a high sedimentation rate. This test measures inflammation in your body. Your doctor will also check for anemia, high levels of protein in your body, abnormal white blood cells, and reduced levels of hemoglobin. (Hemoglobin is a protein in red blood cells that carries oxygen to your tissues.)
Your doctor may schedule an ultrasound to check for inflammation in your joints and tissues. This test uses sound waves to create images of the soft tissue in different parts of your body.
There is a link between polymyalgia rheumatica and giant cell arteritis. Therefore, your doctor may recommend an outpatient procedure to remove a small sample (biopsy) from an artery in your temple. This sample is sent to a laboratory and checked for signs of inflammation. Biopsies are only necessary if your doctor suspects inflammation in the blood vessels.
Signs of inflammation in the blood vessels include:
- a persistent headache
- blurred vision
- double vision
- tenderness in the scalp
- jaw pain
Treatment for Polymyalgia Rheumatica
There is no cure for this disorder. However, there are medications that can improve your symptoms. Your doctor will prescribe a low-dose corticosteroid (such as prednisone) to help reduce inflammation. The typical dosage is 10 to 20 milligrams per day. Symptoms generally improve between one and three days after starting treatment.
If your condition does not improve, polymyalgia rheumatica may not actually be the cause of your pain and stiffness. In this case, your doctor will run additional tests to check for other rheumatic disorders such as neck or back pain, osteoarthritis, and rheumatic fever.
While corticosteroids are effective in the treatment of this disorder, these drugs do have side effects. Long-term use of prescription steroids increases your risk of:
- high blood pressure
- high cholesterol
- diabetes (high levels of sugar in the blood)
- osteoporosis (loss of bone density)
- cataracts (clouding that develops in the lens of the eye)
For this reason, your doctor will reduce your dosage after two, three, or four weeks of treatment. To reduce the risk of side effects while taking a corticosteroid, your doctor may recommend a daily calcium and vitamin D supplement, as well as physical therapy. Therapy helps improve your strength and increases your range of motion. Supplements are commonly recommended if you’re taking steroids for more than three months.
Your doctor will monitor your health during treatment. He or she may periodically order blood tests to check your cholesterol and blood sugar levels, recommend annual eye exams, and schedule periodic bone density tests. This test measures bone density in different parts of your body to check for signs of osteoporosis.
Long-Term Outlook for Polymyalgia Rheumatica
There is no cure for polymyalgia rheumatica. If left untreated, this inflammatory disorder can cause disabilities. You may become unable to complete simple tasks on your own, such as bathing, getting dressed, and combing your hair. However, this condition typically goes away after two to six years of treatment.