The rapid onset of symptoms also suggests that polymyalgia rheumatica may be triggered by an infection. However, no such link has been found. The symptoms of polymyalgia rheumatica can be similar to those of other inflammatory conditions, including lupus and rheumatoid arthritis. To make an accurate diagnosis, your doctor will perform a physical exam and run several tests to check for inflammation and blood abnormalities. During the exam, your doctor may gently move your neck, arms, and legs to evaluate your range of motion.
These tests will measure your erythrocyte sedimentation rate ESR and C-reactive protein levels. An abnormally high sedimentation rate and elevated C-reactive protein levels suggest inflammation, if active infection has been excluded. Your doctor may also schedule an ultrasound to check for inflammation in your joints and tissues.
An ultrasound uses high-frequency sound waves to create detailed images of the soft tissue in different parts of your body. This can be very helpful in distinguishing polymyalgia rheumatica from other conditions that cause similar symptoms.
This biopsy is a low-risk procedure that involves removal of a small sample of tissue from an artery in your temple. The sample is sent to a laboratory and analyzed for signs of inflammation. A biopsy is only necessary if your doctor suspects inflammation in the blood vessels.
But with the proper treatment, symptoms can improve in as little as 24 to 48 hours. Your doctor will prescribe a low-dose corticosteroid , such as prednisone , to help reduce inflammation. The typical dosage is 10 to 30 milligrams per day. Although corticosteroids are effective in treating polymyalgia rheumatica, these drugs do have side effects. Long-term use of these medications increases your risk for:. To reduce your risk for developing side effects during treatment, your doctor may recommend that you take a daily calcium and vitamin D supplement.
Your doctor may also suggest physical therapy to help improve your strength and increase your range of motion. You can shop for calcium supplements and vitamin D supplements online. Maintaining a healthy lifestyle can also help reduce the side effects of corticosteroids. Involvement of the upper arms, with trouble raising them above the shoulders, is common. Sometimes, aching occurs at joints such as the hands and wrists.
Achiness is always worse in the morning and improves as the day goes by. Yet inactivity, such as a long car ride or sitting too long in one position, may cause stiffness to return.
Stiffness may be so severe that it causes any of these problems:. The cause of polymyalgia rheumatica PMR is unknown. PMR does not result from side effects of medications. The abrupt onset of symptoms suggests the possibility of an infection but, so far, none has been found.
Recent research suggests that inflammation in PMR involves the shoulder and hip joints themselves, and the bursae or sacs around these joints. So pains at the upper arms and thighs, in fact, start at the nearby shoulder and hip joints. PMR should not be confused with fibromyalgia , a poorly understood syndrome that unlike PMR has no evidence of inflammation. Polymyalgia rheumatica may be hard to diagnose. Because rheumatologists are experts in diseases of the joints, muscles and bones, they can recognize the diagnosis of PMR and expertly manage its treatment.
The dose will gradually be reduced every 1 to 2 months. Although your symptoms should improve within a few days of starting treatment, you'll probably need to continue taking a low dose of prednisolone for about 2 years.
Polymyalgia rheumatica often improves on its own after this time. However, there's a chance it will return after treatment stops. This is known as a relapse. Do not suddenly stop taking steroid medicine unless your doctor tells you it's safe to stop. Suddenly stopping treatment with steroids can make you very unwell. You may feel depressed and suicidal , anxious or confused.
Some people also have hallucinations , seeing or hearing things that are not there. Get immediate medical advice if you think you've been exposed to the varicella-zoster virus or if a member of your household develops chickenpox or shingles.
Ensuring you get enough calcium and vitamin D , and that you do some weight-bearing exercise will reduce the risk of getting osteoporosis. Too much exercise is likely to make your symptoms worse, but activity usually helps to ease pain and stiffness in the muscles of the shoulders, hips and thighs.
Physiotherapy , including range of movement exercises for the shoulders, can help to reduce pain and maintain mobility. Weight-bearing exercise is good for maintaining bone strength and reducing the risk of osteoporosis.
Weight-bearing exercise is anything like jogging, walking, tennis, dancing or lifting weights, where some force or the weight of the body is impacted on bones during the exercise. This is in contrast to swimming, for example, where the water supports the weight of the body.
Walking is usually the most suitable weight-bearing exercise for people with polymyalgia rheumatica. Sitting for any length of time may cause stiffness, making activities such as driving more difficult. Stop from time to time on a long journey to stretch your shoulders, arms and legs. Simple measures such as a hot bath or shower can help to ease pain and stiffness, either first thing in the morning or after exercise.
A pint of milk a day, together with a reasonable amount of other foods that contain calcium, should be enough. The best source of vitamin D is sunlight on bare skin. These can be bought from supermarkets and health food shops. You can also discuss this with a pharmacist. There are some at risk groups who are advised to take vitamin D supplements all year round, including:. We explain which foods are most likely to help and how to lose weight if you need to.
Find out more about exercising with arthritis and what types of exercises are beneficial for certain conditions. I was 57 when I developed polymyalgia rheumatica and giant cell arteritis. I was head of news and current affairs at Channel Four television and a single parent of a child of It began with a very sore neck.
Then my shoulders started to ache. On a few mornings, when I woke up, I found it difficult to move my arms, though my hands moved easily. The problem would wear off quickly, and I would forget about it. Although I was young to get the condition, I knew I had polymyalgia rheumatica, as my mother had it. I was given a blood test to check inflammation levels and was put onto steroid tablets.
My daughter was very upset and frightened. I would have to go to bed as soon as I got home. Sometimes during the day, I would get into my car in the car park and sleep.
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