Polymyalgia Rheumatica
Polymyalgia rheumatica (PMR) is a prevalent condition characterized by widespread aching and stiffness, predominantly affecting the upper arms, neck, lower back, and thighs. Commonly experienced as heightened discomfort in the mornings, PMR does not typically involve joint swelling, making it challenging to diagnose.
It may coincide with giant cell arteritis, an autoimmune disorder. While PMR primarily affects individuals over 50, women are slightly more susceptible, and Caucasians are at higher risk, though it can affect anyone. Despite its prevalence, the exact cause of PMR remains unknown, and it is not attributed to medication use.
However, inflammation plays a significant role in the condition, with research suggesting a link to inflamed bursae in the shoulders or hips.
What are the common symptoms of PMR?
The hallmark symptoms of PMR include widespread muscle aches and stiffness, often emerging suddenly and affecting both sides of the body. Activities like raising arms over the shoulders or performing simple tasks with hands and wrists may become challenging due to discomfort.
Morning stiffness is common, gradually improving throughout the day, while prolonged inactivity exacerbates stiffness and aches. Severe symptoms can disrupt sleep and hinder daily activities like dressing or getting in and out of a car or sofa.
What are the treatments for PMR?
Diagnosing PMR can be challenging, but rheumatologists employ blood tests to detect elevated inflammation markers like erythrocyte sedimentation rate and C-reactive protein. Low-dose corticosteroids, such as prednisone, effectively alleviate aching and stiffness, with dosage adjusted based on symptom response.
While some patients may require corticosteroids for up to three years, tapering off is possible if symptoms improve. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium are ineffective for PMR management.
How to live with PMR?
With proper treatment, individuals with PMR can regain normalcy in their lifestyle and engage in regular exercise. However, regular check-ups are crucial to monitor and manage potential side effects of corticosteroids, including high blood pressure, osteoporosis, weight gain, cataracts, sleep disturbances, and skin issues.
Older patients may require additional osteoporosis medications to prevent fractures. As PMR can coexist with giant cell arteritis, vigilance for symptoms such as headaches, vision changes, or fever is essential, warranting prompt medical attention.
About Dr. Shalene Badhan
When it comes to managing rheumatologic conditions, empathy is as crucial as expertise. Dr. Shalene Badhan, our lead Rheumatologist and an Internal Medicine specialist, embodies both. Having been diagnosed with psoriasis and psoriatic arthritis herself, Dr. Badhan brings a unique perspective to her practice, combining professional excellence with personal insight. Her journey through diagnosis, treatment, and daily management of autoimmune diseases allows her to connect with her patients on a profound level, offering not just medical advice but also understanding and solidarity.
