What is polymyalgia rheumatica?
Polymyalgia rheumatica – condition leading to severe morning stiffness and pain in the muscles of the shoulders, neck, spine, hips and thighs. The name “polymyalgia rheumatica” simply means rheumatic pain in many groups of muscles. Polymyalgia rheumatica almost always occurs in people older than 50 years. Women suffer from polymyalgia rheumatica more often than men.
What causes it?
The reasons are not currently known. When a biopsy (examination) of painful muscle under the microscope, as a rule, does not show any significant changes in the structure of the muscles. Often there is a slight inflammation of the joints, but it is not sufficient to explain the severe symptoms of the disease.
Weight loss, fever and fatigue with changes in blood means that it is – a disease of the whole body, not just the muscles. Hint to unraveling the causes of disease must lie in the fact that it affects only people who are aged 50 years or older.
It was noted that some cases of the disease began after suffering a ‘flu’. Perhaps the virus provokes changes in the way of the defense mechanisms of the body.
We prove a genetic predisposition to the disease.
The diagnosis of polymyalgia rheumatica is difficult to place. Typically, the disease is detected in time. Sick for several weeks, and sometimes years, misdiagnosed as primary manifestation of the disease – pain.
The disease develops acutely, including overall health. Often, patients can call the day and hour, when suddenly and without apparent reason, there are intense pain in the muscles jerking, cutting, pulling character. The patient goes to sleep “healthy” and in the morning can not get out of bed because of severe pain and stiffness in muscles. Because of the pain of motion becomes limited: the sick is hard to get up, sit down, raise your hands, bring them behind your back, you can not enter without the help of transportation, etc. It is important to observe how the patient rises from bed, first slowly, wincing in pain, turns on his side, pulls his legs to his stomach, pulls them out of bed, leaning his arms, sits down with difficulty and only then, as with his hands, stands up.
In other cases, more gradual start. The process may begin with a little stiffness in one muscle group (eg, shoulder), and after a few weeks to engage the back muscles, buttocks and thighs. If not treated, the severity of symptoms may change over months.
Muscle pain and stiffness in the mornings and harder to decrease during the day. In addition, a sense of constraint appears after any period of immobility.
In addition to complaints of muscle pain, people with polymyalgia rheumatica noted weakness and fatigue, poor appetite, fever and night sweats, weight loss and depression. With these complaints are often becomes sick, and in some cases, these symptoms are much more pronounced than the muscle pain and stiffness.
Arthritis with polymyalgia rheumatica usually appear within a few months after the onset of muscle pain. In many cases, patients were absorbed by muscle aches, arthritis, do not notice, and the changes of the joints revealed only after a careful examination: visible joint swelling, tenderness and pain with passive motion. The process can be either bilateral or unilateral. Determine the prescription arthritis is impossible. In severe cases, the possible loss of earning capacity.
How polymyalgia rheumatica is associated with other diseases?
Most people with polymyalgia rheumatica are only complaints about muscle pain and stiffness, but may develop arthritis.
Some people with polymyalgia rheumatica (10%), there is a condition involving blood vessels, called “temporal arteritis” or “giant cell arteritis“. Temporal arteritis can occur simultaneously with polymyalgia rheumatica, but may precede it, or (chasche!) to join a much later date.
How to diagnose polymyalgia rheumatica?
Unfortunately, there is no specific test that tells us that a person is sick or not sick polymyalgia rheumatica. If polymyalgia rheumatica occurs suddenly, it is easy to diagnose because its symptoms are pronounced. More difficult to diagnose when the disease is “creeping” for several months.
Many older people experience pain and suffering from a variety of reasons, and for the doctor and the patient is easy to ascribe the symptoms of polymyalgia rheumatica age, restlessness or rheumatic fever. Symptoms such as weakness, fever and weight loss can cause other diseases such as cancer or infection, and depression with polymyalgia rheumatica may be mistaken for mental illness.
Accurate description of the symptoms is very important for doctors to diagnose as early as possible.
What can you do?
In the event you or your family the above symptoms should contact a doctor.
Because the disease is in the case of early treatment has a favorable course, you need as soon as possible to begin treatment. Then the sick person in a few years all will forget about their disease and will continue to live a full life.
What can a doctor do?
Diagnosis is based on external examination (presence of pain in the muscles of at least two of the three areas – neck, shoulder and pelvic girdle with the following features: localization in the neck, shoulders, mid sections shoulders, buttocks, thighs, in the distal extremities ( below the elbow and knee) pain is not the case), the results of regular blood tests (increase in erythrocyte sedimentation rate (ESR), mild anemia), blood biochemical analysis (the study of acute phase proteins of inflammation).
Doctor may prescribe medication to control the efficacy and tolerability of therapy, if necessary, to carry out the correction. Treatment usually involves hormones (corticosteroids), if necessary, nonsteroidal anti-inflammatory drugs and chemotherapy.
When you join Dr. giant cell arteritis in time to supply the appropriate diagnosis and treatment will tighten in order to avoid complications.
There are two phases of the disease. In the first phase of all clinical manifestations of the most pronounced, and then they are part and begins the second phase of the disease, when remains one of the relatively mild symptoms: slight stiffness, minor pain, which completely resolved within an average of 2 years.
If symptoms return, then resume treatment.
Polymyalgia rheumatica is not complicated by the development of giant cell arteritis, is benign, does not cause disability and deformity of the limbs. Pain and stiffness are reduced, and patients recover quickly and return to normal life.