Polymyalgia rheumatic is syndrome characterised by muscle pain. Typically, this muscle pain is usually localised around the neck, shoulders and hips – though it may occur elsewhere. Treatment options are limited, but usually involve placing the patient on a course of corticosteroids, which may last up to 2-3 years in many cases.
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Symptoms of polymyalgia rheumatica depend on which part of the body it affects, and the severity with which the patient has the condition. Notwithstanding this, there are numerous hallmark symptoms that have come to typify this condition, such as:
Muscle pain and stiffness characterise the main symptoms of polymyalgia rheumatica, particularly when it affects the neck, shoulder and hips – though the pain may occur elsewhere. Patients also find themselves with a suppressed appetite, which may lead to weight loss and fatigue. It’s also not uncommon for patients to have a low-grade fever with this syndrome. A sizeable proportion of patients, with these long-term symptoms, may develop depression.
The cause of polymyalgia rheumatica is not well understood. However, various factors conspire in the production of its symptoms, including:
The inflammatory response derives from the body’s heightened immune response. This effect is detected by testing blood for ESR and C-reactive protein. Many patients with temporal arteritis also suffer from polymyalgia rheumatica, meaning the former is at least an indirect cause of the latter. Another cause is genetic factors, as it appears certain individuals may be pre-disposed to the syndrome, particularly if these individuals are subsequently exposed to certain viral infections.
Polymyalgia rheumatica is quite difficult to diagnose. This is because the primary symptom – muscle pain – is relatively non-specific. Moreover, there is no biomarker test to diagnose the syndrome either. Diagnosis may, however, be determined by the following factors:
Muscle pain localised to the shoulder and hip region is typical of polymyalgia rheumatica, and this may be determined by physical examination. In addition, blood test results – specifically looking at ESR and C-reactive protein – may determine if inflammation is present or not. Patients with temporal arteritis typically experience polymyalgia rheumatica – and this may be looked into by the physician in question.
Patients with polymyalgia rheumatic have limited treatment options. The type of treatment chosen depends on the age and health status of the patient, as well as whether they are taking any medications. Treatment options include:
Corticosteroid use – typically prednisone – is the mainstay of treatment. The patient may be on therapy for a considerable period of time, sometimes up to 3 years. NSAIDs, which are non-steroidal anti-inflammatory drugs, may be used in conjunction with corticosteroids during this period. Patients should also exercise to maintain muscle tone, and eat healthily to maintain a durable immune system throughout treatment.
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