Polymyalgia Rheumatica, abbreviated as PMR, is an inflammatory ailment that induces intense pain and lack of mobility in the joints, particularly in the shoulders and hips. Quite often, the pain in the shoulders extends to the upper arms, while discomfort in the hips radiates down, inducing low back pain and aching, strain in the thighs.
This discomforting joint disorder occurs primarily in elderly men and women, with the age of onset of symptoms usually being 50 years or older and, in some cases, PMR develops only above the age of 65 – 70 years. PMR rarely affects younger individuals who are less than 50 years of age and also arises more commonly in women than in men. Since the symptoms of PMR overlap with rheumatoid arthritis and also resemble fibromyalgia, it is vital to rule out these debilitating illnesses and detect cases of polymyalgia rheumatica accurately.
Polymyalgia rheumatica arises alongside another malady known as giant cell arteritis in some people. Giant cell arteritis, also called temporal arteritis, is a much more severe condition in which the lining of the arteries – blood vessels that carry blood from the heart to the other organs, becomes inflamed and this obstructs circulation within the body. It also triggers headaches, impaired vision, aching in the face and jaws as well as deterioration of tissues in the scalp. When PMR develops along with giant cell arteritis, it poses life-threatening situations, and the affected person must seek immediate medical care to ensure timely and effective treatment and prevent grave health complications.
Causes Of Polymyalgia Rheumatica:
The actual reason why polymyalgia rheumatica occurs is yet to be determined, but healthcare specialists and medical researchers attribute two main aspects to be the causative factors:
Although the precise genes responsible for PMR are yet to be identified, medical experts state that gene variations in the body could trigger this inflammatory condition.
Many medical scientists hypothesize that a pathogenic microbe such as a virus that emerges in specific seasons could trigger polymyalgia rheumatica, since PMR affects older individuals in periodic cycles that coincide with extreme weather conditions and yearly flu occurrences.
The typical indications associated with polymyalgia rheumatica are:
- Stiffness in the joints of the shoulder, hips, back, knees, especially in the morning or after prolonged sedentary phases
- Shoulder pain
- Aching in the hips, thighs, buttocks
- Fatigue and muscle weakness
- Intense pain in the upper arm, as well as joints of the elbows and wrists
Since polymyalgia rheumatica affects a person’s ability to be physically active and hampers productivity at work and home, accompanying signs of fever, depression and loss of appetite also develop alongside joint pain.
The doctor conducts a physical exam and analyses the patient’s ease of moving and flexing their hip and shoulder joints. The range of motion of the joints is also measures by moving the head, neck, arms and legs in different directions to determine the extent of stiffness and pain.
Furthermore, the healthcare provider collects a blood sample to investigate the presence of inflammatory qualities by two specific assays – the erythrocyte sedimentation rate (ESR) and C-reactive protein test (CRP).
Imaging tests of ultrasound and MRI scans are also conducted, to gauge if there are any abnormal swellings or signs of inflammation and stiffness in the shoulder and hip joints of the patient.
Once the diagnosis of polymyalgia rheumatica is confirmed and the doctor has ruled out the possibility of other joint disorders like rheumatoid arthritis, osteoarthritis, then the primary mode of treatment is by means of prescription medications.
The healthcare provider prescribes oral steroid medicines to be taken at a precise dose usually for few months up to one year, depending on the severity of symptoms. These help to alleviate joint pain and improve mobility of the shoulders, upper arms and hips in the elderly.
Additionally, bone-fortifying supplements of calcium, vitamin D are also prescribed to enhance bone and joint strength and cope with the severe bouts of pain. The doctor also advises the patient to go for physical therapy sessions, wherein the physiotherapist helps them perform various stretching exercises to improve the range of motion of the shoulder, hip joints, mitigate joint pain and restore ease of physical movement and activity in them.