Medical experts have not yet found the exact cause of polymyalgia rheumatica, but they have found that two factors are involved:

• Certain genes or gene variations might increase the risk of polymyalgia rheumatica.
• Environmental factors, perhaps exposure to a virus, might trigger the disease.

Diagnosis of Polymyalgia Rheumatica

Polymyalgia rheumatica is often mistaken for rheumatoid arthritis because the two conditions have similar symptoms. Our rheumatologists have extensive experience in diagnosing and treating diseases that affect joints, bones, muscles, and the immune system, and we conduct a comprehensive evaluation that includes:

• Discussion of symptoms
• Discussion of personal and family medical history
• Physical exam, especially of the joints
• Appropriate laboratory and diagnostic testing

To confirm a diagnosis of polymyalgia rheumatica, our doctors might recommend one or more tests, such as:

• Blood test to look for signs of inflammation, the body’s natural response to illness or injury, such as high levels of C-reactive protein or an elevated erythrocyte sedimentation rate
• Magnetic resonance imaging (MRI) scan of joints to look for other causes of shoulder and hip pain
• Ultrasound to distinguish between polymyalgia rheumatica and other conditions with similar symptoms

Risk Factors for Polymyalgia Rheumatica?

While researchers don’t fully understand what causes polymyalgia rheumatica, they know risk factors include:

• Age: Polymyalgia rheumatica most commonly affects people over the age of 50. And rates of the disease increase with age. It’s most prevalent between the ages of 70 and 75.
• Sex: The condition affects people assigned female at birth (AFAB) more often than people assigned male at birth (AMAB).
• Ethnic and racial background: Caucasian people, especially people of Northern European ancestry, experience the condition more often than any other ethnic or racial group.

Complications of Polymyalgia Rheumatica?

Left untreated, polymyalgia rheumatica can interfere with your mobility. This can make it hard for you to perform your daily activities including bathing, dressing, brushing your hair, getting up from the couch and getting in and out of your car. Raising your arms over your shoulders may be particularly difficult.

Polymyalgia rheumatica can be associated with giant cell arteritis, which can cause inflammation of your aorta, the major artery that transfers blood from your heart to the rest of your body. This can result in a potentially life-threatening aortic aneurysm.

Prognosis of Polymyalgia Rheumatica

With treatment, the symptoms of polymyalgia rheumatica typically lessen or disappear altogether within days. Early diagnosis and treatment can increase your chances of quickly recovering from the condition. Most people go on to live typical, productive lives. Severe impairment and disability are rare.

Researchers have recently discovered that people with polymyalgia rheumatica are at a higher risk for developing a condition called atherosclerosis. But this doesn’t appear to affect life expectancy.

How is Polymyalgia Rheumatica Treated?

Polymyalgia rheumatica treatment begins with a low dose of corticosteroids. Your healthcare provider may recommend 10 mg (milligrams) to 15 mg per day of prednisone, which may rapidly relieve your pain and stiffness. If your symptoms improve, the steroid is gradually lessened over one to two years. In some instances, relapses may occur, and you may need a low dose of steroids long-term to prevent flares. Sometimes, other medications are needed to help control the inflammation and lower steroid dose.

It’s important that your provider monitors you for any potential side effects. Side effects of long-term treatment with steroids may include:

• Weight gain
• Osteoporosis
• High blood pressure (hypertension)
• Cardiovascular disease
• Diabetes
• Thinning of your skin (skin atrophy)
• Cataracts

Researchers have studied other drugs for the treatment of polymyalgia rheumatica, including immunosuppressants like methotrexate, but the results were mixed. The U.S. Food and Drug Administration (FDA) approved a biologic medication called tocilizumab to treat giant cell arteritis and rheumatoid arthritis. But researchers need more data to determine if the drug is safe and effective for the treatment of polymyalgia rheumatica.

Rest and exercise are also important factors in the treatment of polymyalgia rheumatica. Regular exercise can help you maintain muscle strength and joint flexibility. Good forms of exercise include:

• Riding a stationary bike
• Swimming
• Walking

Your provider may also recommend physical therapy to help with discomfort and to maintain your mobility.

Does Polymyalgia Rheumatica Go Away?

With treatment, symptoms of polymyalgia rheumatica resolve within a few days. Treatment duration is generally one to two years, but in some cases, longer treatment is necessary and relapses may occur. In some cases, people may require lifelong treatment with a low dose of prednisone (2 mg to 5 mg daily) to prevent recurrence.

Without treatment, generally polymyalgia rheumatic doesn’t get better. However, in some cases, the condition may go away on its own after a year. It may take up to five years before the condition disappears completely.

How do I Take Care of Myself?

There are steps you can take to manage your symptoms and side effects of medications. It’s important to maintain proper nutrition and take your medications as prescribed. In addition, make sure to get some form of physical activity every day but also allow your body to rest. Once your aches and pains start to go away, you may return to all of your normal daily activities.

When Should I See my Healthcare Provider?

Even low-dose corticosteroids can cause side effects. If you experience any of the following, contact your healthcare provider:

• Weight gain
• High blood pressure
• Sleeplessness
• Bruising or thinning of your skin
• Cataracts
• Osteoporosis

Polymyalgia rheumatica may overlap with giant cell arteritis, so let your provider know if you develop any symptoms of the disease, including:

• Headaches
• Vision changes
• Fever
• Fatigue
• Loss of appetite
• Jaw pain
• Tenderness around your scalp

Reference:

https://utswmed.org/conditions-treatments/polymyalgia-rheumatica/

https://my.clevelandclinic.org/health/diseases/25215-polymyalgia-rheumatica