rheumatica is a syndrome characterized by severe
pain and stiffness in the muscles of the neck,
shoulder girdles, low back, hips and thighs.
There is no corresponding weakness of the
It is thought
that polymyalgia rheumatica is a result of blood
vessels becoming inflamed.
polymyalgia rheumatica actually comes from Greek
words. In Greek, 'poly' means 'many,' 'my'
means 'muscle,' and 'algia' means 'pain' (many
muscle pain) and 'rheumatica' refers to 'muscle
and soft tissue.'
associated with polymyalgia rheumatica is called
giant cell arteritis. It sometimes occurs in
people who have polymyalgia rheumatica. It
causes the arteries on the upper front side of
the head, called the temporal arteries, to
narrow. The arteries can become blocked and
this can result in loss of vision.
common is polymyalgia rheumatica?
often appears in women of middle age.
arteritis affects both men and women who are
often over the age of 50.
people who develop giant cell arteritis also
have polymyalgia rheumatica.
develop polymyalgia rheumatica more often
Polymyalgia rheumatica predominantly affects
Caucasian women over the age of 50. Giant cell
arteritis affects both men and women, usually
over 50 years of age, who may or may not have
the warning signs of polymyalgia rheumatica?
The warning signs
of polymyalgia rheumatica include:
- Severe pain and stiffness in the neck,
shoulders, lower back, hips or thighs
- Low energy and fatigue.
- Profuse sweating during sleep. This is
called night sweats.
- Loss of appetite.
- Slight fever.
- Anemia. This is a condition of the
blood that can cause a person to look pale,
and feel weak, sleepy and dizzy.
The warning signs of giant cell arteritis
- Tenderness of skin on the forehead.
- Redness and swelling of the blood
vessels on the side of the head. These may
be painful to press on.
- Changes in vision such as blurred
vision, blind spots or seeing double.
- Pain in the jaw, often while chewing
- Problems with hearing.
- Sore throat and coughing.
you have polymyalgia rheumatica you will
probably experience muscle pain and stiffness in
specific parts of your body, usually the neck,
shoulder, lower back, hips and/or thighs.
However, there are a variety of other symptoms
that may indicate the presence of polymyalgia
With giant cell
arteritis, the whole upper front side of the
head will become extremely tender. The larger
arteries on the side of the skull redden, swell,
and are painful when pressed. Other symptoms
include changes in vision such as blurring,
blind spots, or seeing double; pain in jaw,
especially while chewing; dizziness; hearing
problems and sore throat or cough.
The danger of
giant cell arteritis is that it can cause
blindness. Therefore, if you have already been
diagnosed with polymyalgia rheumatica and
develop any of the giant cell arteritis, contact
your doctor immediately.
causes polymyalgia rheumatica?
people with polymyalgia rheumatica have
other family members with it.
has shown a casual link.
- The exact
cause of polymyalgia rheumatica is not
one knows what causes polymyalgia rheumatica.
Genetic factors may play a part, and so the
disease might be hereditary.
you do about polymyalgia rheumatica?
doctor may order certain laboratory tests.
He or she might perform a test called an EMG.
This test measures the electric current in
your muscles. He or she might also cut away
a very small piece of muscle to be tested in
treatment of polymyalgia rheumatica is done
to reduce the pain. The disease usually
goes away on its own, but this can take a
much as you can about this disease.
Speaking with people who are specialists in
arthritis care can provide you with the
information you need.
- If your
doctor thinks you have polymyalgia
rheumatica, he or she may refer you to a
rheumatologist (room-a-tol-o-jist). A
rheumatologist is a doctor who has received
special training in the diagnosis and
treatment of problems with muscles, joints
To be able to diagnose
whether you have polymyalgia rheumatica, your
doctor will perform a physical examination and
probably order laboratory tests. One test,
called a biopsy, involves cutting away a very
small segment of muscle tissue for analysis. If
you have polymyalgia rheumatica you will have an
elevated erythrocyte sedimentation rate (ESR).
This means that you have a higher level of red
blood cells that are settling in the muscle.
Your doctor may also perform a test called an
EMG. With this test electrodes are taped to
your skin and the electric currents running
through your muscles are recorded.
To test for giant cell arteritis, your doctor
may perform a biopsy of a very small amount of
tissue from the inflamed area. If you have
giant cell arteritis the tissue will contain
cells that are larger than normal and that have
multiple nuclei (or centres). These are called
arteritis also goes away on its own over a
period of years. However, treatment is
essential to minimize the chances of blindness.
involvement in developing your prescribed
treatment plan is essential.
- Non-steroidal anti-inflammatory drugs (NSAIDs
- pronounced en-seds) are sometimes used to
treat polymyalgia rheumatica. These are a
type of medication that helps reduce pain
and swelling and decrease stiffness.
NSAIDs reduce pain when taken at a low dose, and
relieve inflammation when taken at a higher
dose. NSAIDs such as ASA (Aspirin, Anacin, etc.)
and ibuprofen (Motrin IB, Advil, etc.) can be
purchased without a prescription. Examples of
NSAIDs that require a prescription include
Naprosyn, Relafen, Indocid, Voltaren, Feldene,
and Clinoril. The various NSAIDs and AspirinŽ,
if taken in full doses, usually have the same
levels of anti-inflammatory effect. However,
different individuals may experience greater
relief from one medication than another. Taking
more than one NSAID at a time increases the
possibility of side effects, particularly
stomach problems such as heartburn, ulcers and
bleeding. People taking these medications should
consider taking something to protect the
stomach, such as misoprostol (Cytotec).
cortisone is most often prescribed for
polymyalgia rheumatica and for giant cell
arteritis. Cortisone is a steroid that
reduces inflammation but should be used with
care due to the possible implications of
Cortisone is a steroid that reduces inflammation
and swelling. It is a hormone naturally
produced by the body. Corticosteroids are
man-made drugs that closely resemble cortisone.
The most common form of corticosteroid is called
prednisone, taken in pill form. Prednisone use
needs to be carefully monitored because of its
many side effects, and the drug must never be
Some of the
side effects from long-term use include
cataracts, high blood pressure, sleep problems,
muscle loss, bruising, thinning of the bones
(osteoporosis), weight gain and increased risk
of infections. For treatment of polymyalgia
rheumatica the dose is rapidly decreased to the
lowest doses possible. These doses may need to
be maintained for some time: anywhere from 18
months to three years. The goal with this and
most drugs is to find the lowest effective dose
that will avoid as many of the side effects as
- Exercise may help reduce pain and will
keep muscles from becoming weak.
- The key is to strike a balance between
too much activity (which can strain painful
muscles), and too little activity (which can
increase pain and stiffness and lead to
- There are three types of exercises:
- Range of motion exercises reduce
stiffness and help keep your joints
moving. A range of motion exercise for
your shoulder would be to move your arm
in a large circle.
- Strengthening exercises maintain or
increase muscle strength
- Endurance exercises strengthen your
heart and give you energy. These
exercises include walking, swimming and
pool therapy is highly recommended.
Muscles and the other tissues that hold joints
together weaken when they aren't moved enough,
so the joint loses its shape and function.
Exercise may help reduce the pain of polymyalgia
and can help you feel better overall. Moderate
stretching exercises will help relieve pain and
keep the muscles and tendons more flexible and
strong. Low-impact exercises like swimming,
walking, water aerobics and stationary bicycling
can all reduce pain while maintaining strength
and flexibility. Always consult a doctor before
beginning an exercise program.
- Applying heat helps relax aching
muscles, and reduces pain and soreness. For
example, take a hot shower.
- Applying cold helps to lessen the pain
and swelling. For example, put an ice pack
on the area that is sore.
Heat or cold
application can provide temporary relief of
pain. Heat helps to reduce pain and stiffness
by relaxing aching muscles and increasing
circulation to the area. There is some concern
that heat may worsen the symptoms in an already
inflamed joint. Cold helps numb the area by
constricting the blood vessels and blocking
nerve impulses in the joint. Applying ice or
cold packs appears to decrease inflammation and
therefore is the method of choice when joints
Protect Your Muscles and Joints
- Be kind to your body. After doing heavy
work, or doing the same task over and over,
stop. Slow down by doing an easy task, or
by taking a rest.
- Use your back, arms and legs in safe
ways to avoid putting stress on muscles and
joints. For example, carry a heavy load
close to your body.
- Use helpful devices such as a cart to
carry your grocery bags, or an enlarged
handle that fits over a knife handle so you
can hold it easily. A cart will help you to
walk more safely. A grab bar, which
attaches to a shower, will help you to get
in and out of the tub more easily.
- Maintain a healthy weight to avoid
putting extra stress on your joints.
Protecting your muscles and
joints means using them in ways that avoid
excess stress. Benefits include less pain and
greater ease in doing tasks. Three main
techniques to protect your muscles and joints
alternating heavy or repeated tasks with easier
tasks or breaks, reduces the stress on painful
joints and allows weakened muscles to rest.
muscles and joints wisely helps you use them in
ways that avoid extra stress. Use larger,
stronger joints to carry loads. For example,
use a shoulder bag instead of a hand-held one.
Also, avoid keeping the same position for a long
period of time.
devices, such as canes, luggage carts, grocery
carts and reaching aids, can help make daily
tasks easier. Using grab bars and shower seats
in the bathroom can help you to conserve energy
and avoid falls.
a healthy weight you also reduce stress on your
joints and muscles. If you plan to lose weight,
discuss the best program for you with your
doctor and a dietitian.
- Relaxing the muscles around an inflamed
area reduces pain.
- There are many ways to relax. Try deep
breathing exercises. Listen to music or
relaxation tapes. Meditate or pray.
Another way to relax is to imagine or
visualize a pleasant activity such as lying
on a beach, or sitting in front of a
Developing good relaxation and coping skills can
give you a greater feeling of control over your
arthritis and a more positive outlook.
Polymyalgia rheumatica usually goes away of its
own accord, but it is impossible to predict how
long the disease will last in any person. Once
the pain and stiffness of polymyalgia rheumatica
lessen, all patients are encouraged to resume
their normal activities, trying to strike a
balance between too much activity (which can
strain painful muscles), and too little activity
(which can increase pain and stiffness) and lead
to further weakness.
arteritis appears to run its course over a three
to five year period with severe pain gradually
disappearing. There is also the possibility of
loss of vision. However, with treatment, pain
subsides and vision loss is rare. The symptoms
may recur months or even years after the first
This site is
not intended to give medical advice. Seek the
advice of a professional for diagnosis,
medication, treatment options, and complete
knowledge of any illness. The opinions
expressed here are exclusively my personal
opinions do not necessarily reflect my peers or
professional affiliates. The information here
does not reflect professional advice and is not
intended to supersede the professional advice of