What is ‘polymyalgia rheumatica’?
For many, polymyalgia rheumatica would not seem any different than the kind of arthritis which may be present in many of the elderly individuals. But, in reality, polymyalgia rheumatica refers to an inflammatory condition pertaining to muscles and it is characterized by pain and stiffness of affected muscles like bone and joint pain seen in an arthritic patient.
The condition usually affects the shoulder muscles and can spread to muscles of the upper arm, lower back, buttock as well as to the upper thigh. Such pain would be associated with stiffness of the same muscles and it is not so uncommon to see such patients having restricted movements as well.
Furthermore, these patients will also complain of low grade fever, feeling of unwell, fatigue and sometimes depressive symptoms. But, the level and the intensity of these symptoms could vary greatly and might not be present in all patients with polymyalgia rheumatic as well.
How is it treated?
The million dollar question regarding polymyalgia rheumatic would be whether it’s curable? The answer would be, yes, to a great extent.
The reason for this answer is its rapid response to its recognized treatment, corticosteroids. Secondly, the treatment may have to be continued for few years before the patient would be able to live without needing to take medications. Thirdly, it is possible for these patients to remain symptom free while they take these medications. Fourthly, there is a likelihood of developing side effects in relation to corticosteroid therapy which can introduce new long term problems. Lastly, for a person who developed polymyalgia rheumatic, there is a high chance of recurrence in a later time.
When considering all these elements, it is obvious that the clinicians would not be able to give a patient a clear assurance of a 100% cure but can safely assure a recovery from the current state of immobility and helplessness.
In general, the treatment would start with prednisone tablets of 20 – 30 mg daily and this may have to be continued for few weeks before the drug can be tailored off to a lower level. The low dose of prednisone should be continued for few years after which a gradual reduction and complete omission can be considered.
At the same time, to counteract some of the side effects, especially pertaining to the bones, these patients will also be prescribed vitamin D and calcium as well.
Following settlement of acute symptoms, these patients will also be initiated on physiotherapy which will aim to gain the normal physical mobility and capacity as much as possible.
During the recovery period, it is essential to keep the patients healthy and strong with adequate nutrition, exercises as well as with a sound mentality to achieve the best results of polymyalgia rheumatic treatment.