Introduction
Polymyalgia rheumatica (PMR), often referred to as muskelreumatism, is an inflammatory disorder that causes muscle pain and stiffness, primarily in the shoulders, neck, and hips. The condition typically affects people over the age of 50 and is more common in women. Early recognition and appropriate management are essential to relieve symptoms and prevent complications.
Causes
The exact cause of polymyalgia rheumatica is not fully understood, but several factors are believed to contribute:
- Immune System Dysfunction: PMR is considered an autoimmune condition, where the immune system mistakenly attacks the body’s own tissues, leading to inflammation.
- Genetic Predisposition: A family history of autoimmune diseases may increase the risk.
- Environmental Triggers: Infections or other environmental factors may play a role in triggering the disease.
- Age and Gender: PMR almost exclusively affects individuals over 50 and is more common in women.
Symptoms
The main symptoms of polymyalgia rheumatica include:
- Muscle Pain and Stiffness: Aching and stiffness in the shoulders, neck, upper arms, hips, and thighs, especially in the morning or after periods of inactivity.
- Reduced Range of Motion: Difficulty moving the affected areas.
- Fatigue: General tiredness and reduced energy levels.
- Mild Fever: Low-grade fever may be present.
- Weight Loss: Unintentional weight loss in some cases.
- General Malaise: Feeling unwell or out of sorts.
Diagnosis
Diagnosis is based on clinical evaluation and laboratory tests:
- Medical History: Review of symptoms, duration, and family history.
- Physical Examination: Assessment of muscle tenderness, range of motion, and signs of inflammation.
- Laboratory Tests: Blood tests for markers of inflammation, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which are usually elevated in PMR.
- Exclusion of Other Conditions: Ruling out other diseases with similar symptoms, such as rheumatoid arthritis or fibromyalgia.
Treatment Options
Treatment aims to relieve symptoms, reduce inflammation, and restore function:
- Corticosteroids: Low-dose corticosteroids (such as prednisolone) are the mainstay of treatment and usually provide rapid symptom relief.
- Gradual Dose Reduction: The steroid dose is gradually reduced over time, under medical supervision, to minimize side effects.
- Pain Relief: Over-the-counter pain relievers may be used for additional symptom control.
- Physical Therapy: Gentle exercises to maintain muscle strength and joint flexibility.
- Regular Monitoring: Ongoing assessment to adjust treatment and monitor for complications or side effects of corticosteroids.
- Treatment of Associated Conditions: Some individuals with PMR may also develop giant cell arteritis, a related condition that requires prompt treatment.
Prevention
There is no known way to prevent polymyalgia rheumatica, but early diagnosis and treatment can minimize complications and improve quality of life:
- Awareness of Symptoms: Seek medical advice for persistent muscle pain and stiffness, especially in older adults.
- Regular Follow-Up: Ongoing care with a healthcare provider to monitor treatment response and side effects.
Takeaway
Polymyalgia rheumatica is a treatable inflammatory condition that primarily affects older adults. With early recognition and appropriate corticosteroid therapy, most individuals experience significant symptom relief and can maintain an active lifestyle. If you experience persistent muscle pain and stiffness, consult a healthcare provider for evaluation and personalized care.