Polymialgia rheumatic is a rheumatic disease that most often affects people over 50 years of age. It is manifested by pain that lasts for a long time, including nape and neck. There are also general symptoms, such as low-grade fever, fatigue, sleep disturbances. What are the causes and other symptoms of rheumatic polymyalgia? How is her treatment going?

Polymyalgia rheumatica(PMR, Latinpolymyalgia rheumatica ) is a disease that belongs to the group of the so-called systemic connective tissue diseases. It attacks and causes inflammation of the neck and neck muscles, as well as the shoulder and hip girdles.

Polymialgia rheumatic usually occurs in people over 50 years of age. The incidence of new disease is 20-50 cases / 100,000 general population / year.

Rheumatic polymialgia - causes and risk factors

Polymialgia rheumatic is an autoimmune disease, i.e. in its course, cells of the immune system attack the muscles, causing them to become inflamed. The reasons for this process are unknown.

It has been noticed, however, that polymyalgia rheumatic disease is a disease of elderly people (it is practically not found before the age of 50). Its incidence increases with age. The peak incidence is observed between the ages of 70 and 80.

Gender is also important - women suffer twice as often as men, and geographic location - most cases are recorded in Northern Europe. In the south of our continent, the disease is almost unknown.

Other risk factors are solar radiation and viral infections ( Mycoplasma pneumoniaeandChlamydia pneumoniae ).

Genetic predisposition also plays a role in the development of the disease.

Polymialgia rheumatic - symptoms

The main symptoms of the disease are pain in the muscles of the neck and nape, as well as the shoulder and pelvic girdles (especially with pressure) that lasts longer than 2 weeks. Usually, there is no weakness or muscle wasting. The stiffness of this group of muscles is also characteristic after low physical activity or immobilization (the most common is the so-called morning stiffness - lasting 1 hour after waking up). These symptoms may develop slowly over timewithin months and sometimes increase rapidly.

In addition, symptoms may appear, such as:

  • pasty swelling of hands and feet
  • arthritis (usually knee and sternoclavicular)
  • low-grade fever or fever
  • general malaise
  • sleep disturbance
  • depressive states
  • weight loss
Important

The disease is associated with giant cell arteritis (Horton's disease). According to research, about 20 percent. people suffering from polymyalgia rheumatic have at the same time giant cell arteritis, and in 40-60 percent. people with giant cell arteritis develop symptoms of rheumatic polymyalgia.

Rheumatic polymialgia - diagnosis

The patient should see a rheumatologist who should order blood tests. Accelerated ESR (often>100 ml / h) is characteristic of rheumatic polymyalgia. If symptoms of arthritis develop, an ultrasound may be performed (synovitis of joints and tendon sheaths is evident).

You should also evaluate whether giant cell arteritis is present at the same time.

In addition, the doctor should exclude certain diseases of the bones, joints (e.g. rheumatoid arthritis), muscles (e.g. polymyositis and dermatomyelitis), as well as neoplasms (e.g. multiple myeloma), as they may have similar symptoms like rheumatic polymyalgia.

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Characteristics of rheumatic polymyalgia

  • age - usually affects people over 50
  • duration of symptoms - 2 weeks and longer
  • pain in 2 of 3 muscle areas: nape, shoulder girdle, pelvic girdle
  • morning stiffness - lasts more than 1 hour
  • quick improvement after using 15-20 mg / d. prednisone. 75 percent of patients feel better within a week

Rheumatic polymialgia - treatment

The patient is given glucocorticosteroids - most often prednisone in a dose of 15-20 mg / day. It is characteristic that the administration of the drug in such a dose results in a quick improvement of the patient's condition - even within a few hours, but the pain usually subsides or decreases in intensity within a few days. Thereafter, the dose should be reduced. However, doing so may lead to the relapse of the disease symptoms. Then the amount of the administered drug should be increased again. Alternatively, the patient may be given another drug from the group of immunosuppressive drugs - methotrexate.

Glucocorticosteroids, due to side effects, should be administered in the lowest effective dose and for the shortest possible time.Unfortunately, polymyalgia rheumatic in half of the patients very often requires long-term treatment (up to several years, at least 1-2 years).

If corticosteroids are administered for more than 3 months, the patient should supplement with calcium and vitamin D to prevent the development of osteoporosis.

Rheumatic polymialgia - rehabilitation

When the inflammation is alleviated, rehabilitation is recommended, including exercises that increase the range of motion in the joints, stretching or improving body posture and balance.

Category:

Spine, bones, joints