Polymyalgia rheumatica (PMR) is an inflammatory disorder that primarily affects older adults. It typically causes pain, stiffness, and inflammation in the shoulders, hips, neck, and upper body. The pain and stiffness are usually worse in the mornings and improve throughout the day with activity.
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Rheumatologist discusses what polymyalgia rheumatica is.
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Rheumatologist discusses diagnosis and symptoms of polymyalgia rheumatica.
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Rheumatologist discusses diagnosis and treatment of polymyalgia rheumatica.
Treatment of Polymyalgia Rheumatica
PMR is an inflammatory condition that causes pain and stiffness in the muscles, especially around the shoulders and hips. If left untreated, it can lead to complications such as joint contractures, which result in permanent shortening of the affected muscles or joints.
Seeking medical attention from a healthcare professional is essential in managing PMR effectively. Your local family physician can play a vital role in diagnosing the condition and providing initial treatment. However, given the specialized nature of rheumatic conditions like PMR, a referral to a rheumatologist may be necessary for further evaluation and ongoing management.
A rheumatologist is a specialist who has expertise in diagnosing and treating diseases that affect the joints, muscles, and connective tissues. They can help confirm the diagnosis of PMR and prescribe appropriate medications, such as corticosteroids, which are the mainstay of PMR treatment. Regular follow-up appointments with a rheumatologist are crucial for monitoring the disease progression, adjusting medication dosages, and managing any potential side effects.
The treatment of polymyalgia rheumatica (PR) typically involves medications that help reduce inflammation and manage pain. Here's a summary of the medications commonly used for PR:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs are used to reduce pain and inflammation in PR. While they may not be as effective as prednisone for initial treatment, they can be used in combination with prednisone. NSAIDs can also help lower the dose of prednisone in long-term treatment. Your pharmacist can assist in ensuring you're taking the right medication for your condition.
Disease Modifying Anti-Rheumatic Drugs (DMARDs): DMARDs, such as methotrexate, are typically prescribed for inflammatory arthritis like rheumatoid arthritis (RA). In some cases, a rheumatologist may prescribe DMARDs to treat PR.
Analgesics (Pain Killers): Analgesic medications can help control pain associated with PR. However, it's important to note that they do not address the underlying inflammation or prevent joint damage. Over-the-counter options like acetaminophen or stronger prescription narcotics like morphine can be used.
Corticosteroids (Prednisone): Prednisone is the most commonly prescribed medication for PR. It is a corticosteroid that fights inflammation. Patients often experience improvement in their symptoms within 24 hours of starting prednisone, and the dosage is gradually reduced over time. Calcium and vitamin D supplements may be recommended if you are taking prednisone for three months or longer to protect your bones.
In addition to medications, physical therapy and exercise are beneficial for PR. They can improve pain, stiffness in the shoulders and hips, and help protect the joints from further damage. Regular exercise can also assist in managing fatigue and supporting mental health in individuals with PR.
Diagnosis of Polymyalgia Rheumatica
A rheumatologist is a physician who specializes in treating arthritis and autoimmune disease. Because other diseases can be similar to polymyalgia rheumatica, it’s important to work with a doctor who understands the condition.In order to diagnose polymyalgia rheumatica, your physician will start by taking a complete medical history and physical assessment. Often, the doctor will order blood tests and x-rays to confirm the diagnosis.
Symptoms of Polymyalgia Rheumatica
The most common symptom of polymyalgia rheumatica are intense pain and stiffness in the shoulders and hips. Generally, PR comes on suddenly, sometimes even overnight. Patients often feel their stiffness is worse in the morning or after resting. Some people feel better once they get moving, while others feel pain and stiffness throughout the day. So, if someone you know or yourself has features of polymyalgia rheumatica, you should seek attention with your primary care physician. He or she will do a number of tests and likely send you on to a rheumatologist for consultation.
Who Gets Polymyalgia Rheumatica?
Seeking medical attention from a primary care physician is crucial if someone experiences symptoms suggestive of polymyalgia rheumatica (PMR). The symptoms of PMR include pain and stiffness in the muscles, particularly in the shoulders, neck, and hips, along with fatigue, low-grade fever, and weight loss.
As mentioned, there is a significant overlap between polymyalgia rheumatica and temporal arteritis (giant cell arteritis), so it is important to evaluate the possibility of temporal arteritis in individuals with suspected PMR. Temporal arteritis involves inflammation of the arteries located in the temples and can cause severe headaches, tenderness and pain in the temples, and visual disturbances.
A primary care physician will typically conduct a thorough medical history and physical examination. They may also order blood tests, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, which can indicate the presence of inflammation. If there is a suspicion of temporal arteritis, a referral to a rheumatologist may be recommended.
A rheumatologist specializes in the diagnosis and treatment of rheumatic diseases and will further evaluate the patient. They may order additional tests, such as a temporal artery biopsy, to confirm the diagnosis of temporal arteritis. Once a diagnosis is confirmed, the rheumatologist will develop an appropriate treatment plan, which may involve medications such as corticosteroids to reduce inflammation.
It's important to remember that the information provided here is for general knowledge and educational purposes. For personalized advice and guidance regarding specific medical conditions, it is always best to consult with a healthcare professional.