Do you sometimes feel stiff and achy when you wake up in the morning? Especially in your neck, shoulders, and hips. Do you sometimes find it difficult to change clothes or comb your hair? If you have these symptoms, it could be due to a condition called 'Polymyalgia Rheumatica', which we are going to talk about today. Don't worry, we will talk about this in detail.
What is Polymyalgia Rheumatica?
Simply put, Polymyalgia Rheumatica is a condition that is most common in people over the age of 50, and it causes pain and stiffness in your neck, shoulders, and hips . Sometimes, this pain can spread to your upper arms, thighs, and back. Often, this pain and stiffness is felt equally on both sides of your body.
The most important thing is that this pain and stiffness is most felt when you get up in the morning, or when you try to move after sitting for a while . This stiffness that occurs in the morning can usually last for 30 minutes or more . For some people, this pain can be unbearable, but you may notice that the pain decreases a little when you move around a little, or when you do something useful.
How common is this condition?
In a country like America, it is said that about 50 people out of 100,000 develop this condition each year. It usually affects people over the age of 50. However , it is most common among people between the ages of 70 and 75 .
What are the symptoms of Polymyalgia Rheumatica?
The main symptoms of this condition are sudden onset of pain and stiffness in the large joints of the body, especially the shoulders and hips . You may also feel discomfort in your arms, back, buttocks, and neck. This pain and stiffness usually appear within two weeks, sometimes overnight. Often the pain is felt on both sides of the body. You may have difficulty doing simple tasks like getting dressed or combing your hair.
Imagine how difficult it would be if your shoulders were so stiff and painful that you couldn't even lift your arms to wash your face when you woke up in the morning.
Other symptoms that may be seen include:
- Stiffness that lasts for more than 30 minutes upon waking up in the morning, or after standing up after sitting for a while.
- Feeling lifeless and weak .
- Constant fatigue .
- Feeling generally unwell .
- Food is tasteless .
- Weight loss .
- Swelling in the hands or wrists.
- Having a mild fever .
About 10% to 20% of people with polymyalgia rheumatica may also develop another condition called giant cell arteritis or temporal arteritis. This is also a type of vasculitis, which is inflammation of large blood vessels, such as the aorta, the main blood vessel that carries blood from our heart to the rest of our body. Also, about 40% to 60% of people with giant cell arteritis may also have polymyalgia rheumatica.
What causes this?
Researchers have not yet discovered the exact cause of polymyalgia rheumatica, but there are several factors that are thought to contribute to it:
- Genetics : This means that some genes passed down through generations may influence this.
- Environmental factors : Things like certain infections.
- Aging : Changes in the body occur with age.
- Autoimmune disease: The body's immune system mistakenly attacks its own cells.
- Bursitis is swelling of the small sacs called bursa in the hips or shoulders.
Who is most at risk for this?
Although the exact causes of Polymyalgia Rheumatica are unknown, several risk factors have been identified:
- Age : This condition most often affects people over the age of 50. The likelihood of developing this disease increases with age. It is most common among people between the ages of 70 and 75.
- Gender : This condition is more common among women than men.
- Race and ethnicity : This condition is more common among white people, especially those of Northern European descent, than other ethnic groups.
What complications can this cause?
If left untreated, polymyalgia rheumatica can affect your ability to move your body . This can make it difficult to perform everyday tasks, such as bathing, getting dressed, combing your hair, getting up from the couch, and getting in and out of a car. It can be especially difficult to raise your arms above shoulder level.
Also, Polymyalgia Rheumatica can be associated with Giant Cell Arteritis, which can cause the aorta, the main blood vessel that carries blood from the heart to the rest of the body, to swell. This can lead to a potentially life-threatening condition called an aortic aneurysm.
How do you recognize this?
Polymyalgia Rheumatica can be difficult for a doctor to diagnose because its symptoms are similar to those of other conditions, such as rheumatoid arthritis, spondyloarthritis, pseudogout, myositis, and other connective tissue diseases, as well as degenerative joint disease. Therefore, your doctor will need to rule out these other conditions before diagnosing you with this condition.
Your doctor will ask about your medical history and perform a physical exam . During the exam, they will look for common symptoms of polymyalgia rheumatica and signs of other conditions.
There is no specific blood test for this. However, your doctor may order several blood tests to help rule out other conditions. These may include:
- Complete Blood Count (CBC)
- C-reactive protein (CRP)
- Erythrocyte Sedimentation Rate (ESR)
- Thyroid-stimulating hormone (TSH)
- Creatine Kinase
Sometimes, your doctor can also diagnose the condition by how quickly you respond to a type of medicine called corticosteroids. Many people with this condition feel much better within a few days after starting a low dose of a steroid like prednisone.
How is it treated?
Treatment for polymyalgia rheumatica begins with low-dose corticosteroids . Your doctor may prescribe 10 to 15 milligrams of prednisone per day. This can quickly reduce your pain and stiffness. After your symptoms have subsided, the steroid dose is gradually reduced over a year or two. In some cases, the disease may recur. Then you may need to take low-dose steroids long-term to prevent flare-ups. Sometimes other medications may be needed to control swelling and reduce the dose of steroids.
The most important thing is that your doctor monitors you regularly, because long-term use of steroids can cause side effects.
The following are possible side effects of long-term steroid use:
- Weight gain.
- Osteoporosis (thinning of the bones).
- High blood pressure (Hypertension).
- Cardiovascular disease .
- Diabetes .
- Thinning of the skin (Skin atrophy).
- Cataracts .
Researchers have also studied other drugs that suppress the immune system, such as methotrexate, for treating polymyalgia rheumatica, but the results have been less clear. The U.S. Food and Drug Administration (FDA) has approved the biologic drug tocilizumab for treating giant cell arteritis and rheumatoid arthritis. However, more data is needed to determine whether this drug is safe and effective for polymyalgia rheumatica.
Rest and exercise are two important factors in the treatment of Polymyalgia Rheumatica. Regular exercise helps maintain the strength of your muscles and the flexibility of your joints. Good types of exercise include:
- Riding a stationary bike.
- Swimming.
- Walking.
Your doctor may also recommend physical therapy to reduce discomfort and maintain function.
What can be expected with this situation?
With treatment, the symptoms of polymyalgia rheumatica usually improve within a few days, or even go away completely . The sooner you are diagnosed and treated, the better your chances of recovering from the condition. Most people live normal, productive lives . Severe disability is rare.
Researchers have recently found that people with polymyalgia rheumatica are at an increased risk of developing atherosclerosis, a condition in which fatty deposits build up in the blood vessels and cause them to harden. But this does not appear to affect lifespan.
Can Polymyalgia Rheumatica be completely cured?
With treatment, symptoms of polymyalgia rheumatica usually improve within a few days. Treatment usually lasts about a year or two, but in some cases, treatment may take longer and the disease may recur. Some people may need to take low-dose prednisone (2 to 5 milligrams per day) for the rest of their lives to prevent the disease from returning.
Without treatment, polymyalgia rheumatica usually does not get better. However, in rare cases, the condition may resolve on its own after a year. It may take up to five years for the condition to completely go away.
Can this be prevented?
Because researchers do not know the exact cause of Polymyalgia Rheumatica, the condition cannot be prevented .
How do I take care of myself?
There are things you can do to manage your symptoms and the side effects of your medications. Maintaining a healthy diet and taking your medications as prescribed are important . In addition, make sure to give your body some rest by getting some physical activity every day. Once your body starts to feel less sore and sore, you can resume all of your normal daily activities.
When should you see a doctor?
Even low doses of corticosteroids can cause side effects. If you experience any of the following symptoms, see your doctor:
- Weight gain.
- High blood pressure.
- Insomnia.
- Skin bruising or thinning of the skin.
- Cataracts.
- Osteoporosis .
Polymyalgia Rheumatica can occur together with Giant Cell Arteritis, so tell your doctor if you experience any of the symptoms of that condition. These symptoms include:
- Headache.
- Changes in vision.
- Fever.
- Tired.
- The food is tasteless.
- Jaw pain.
- Pain when touching the area around the scalp.
What questions should you ask the doctor?
When you go to see the doctor, you can ask these questions:
- Why did this happen to me?
- What treatments do you recommend for me?
- What side effects should I watch out for?
- Do I also have Giant Cell Arteritis?
- What are the possible complications of Polymyalgia Rheumatica?
- What can I do to prevent this situation from happening again?
The symptoms of Polymyalgia Rheumatica can be very bothersome, making it difficult to do daily activities. If you experience severe muscle pain and stiffness, see a doctor. Although Polymyalgia Rheumatica can be difficult to diagnose, your doctor can help you figure out what's going on and what treatment is best for you. Living with Giant Cell Arteritis can be challenging for some people. So be sure to talk to your doctor about all of your symptoms.
Take-Home Message
Polymyalgia Rheumatica is a somewhat annoying condition, especially with the pain and stiffness in the morning. But remember:
- This is common in people over the age of 50 , especially women.
- The main symptoms are pain and stiffness in the shoulders, neck, and hips , especially in the morning.
- Although the exact cause is unknown, there are treatments . In most cases, corticosteroids provide quick relief.
- It is very important to diagnose the disease and start treatment early .
- Some people may also develop a condition called 'Giant Cell Arteritis' along with this, so be aware of that as well.
- The most important thing is to talk to your doctor carefully and follow his advice .
Don't worry, with proper treatment and management, you can control this condition and live a good life.
` Polymyalgia rheumatica, joint pain, morning stiffness, corticosteroids, giant cell arteritis, geriatric health, muscle pain
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