Polymyalgia Rheumatica, Symptoms, Causes, Diagnosis, Treatment

Polymyalgia rheumatica can be defined as an inflammatory condition causing muscle pain and stiffness. The literal meaning of word poly means multiple and myalgia means muscle pain so this condition refers to multiple muscular pains. Primary effected sites are shoulders, neck, upper arm and hip. The one set of signs and symptoms is acute with quick progression usually within two weeks. It is commonly an old age disease effecting people above age of 65, rarely occurs below 50 years of age. Polymyalgia rheumatica is associated with giant cell arthritis usually affecting temporal artery thus causing symptoms like headaches, vision difficulties and jaw pain. It is also known as PMR.

Polymyalgia rheumatica symptoms: This disease equally effects both side of the body characterized by aches and stiffness in neck upper arm buttocks and thighs. The stiffness is more intense in the morning, after long periods of inactivity and after long time sitting in one position. The intense stiffness can lead to disturbed sleep. Limited range of motion is one of the polymyalgia rheumatica symptoms. Less commonly it can present as pain and stiffness in wrist or knees. The general associated symptoms of polymyalgia rheumatica are mild or low grade fever, fatigue, malaise, anorexia, weight loss and depression.

Polymyalgia rheumatica causes: The exact polymyalgia rheumatica causes are unknown but two things seems to effect its appearance. Genetic polymorphism in HLA-DRB1*04 alleles, interleukin-1 gene, tumor necrosis factor – alpha gene, interleukin-6 gene and RANTES and some environmental triggers such as virus or seasonal effects are suspected as new cases develop in cycles. Systemic macrophages and T-cell activation is the characteristic of this disease with elevated IL-6 levels causing inflammation of joints and bursae. Giant cell arthritis is closely associated with polymyalgia rheumatica where 15% of people having polymyalgia rheumatica also have GCA while 50% of GCA patients have polymyalgia rheumatica.

Polymyalgia rheumatica diagnosis: Although polymyalgia rheumatica causes pain and stiffness in muscles, all tests performed on muscles such as electromyography and biopsy are normal so the polymyalgia rheumatica diagnosis is done on the basis of general physical examination and tests for diagnosis of inflammation such as increase WBC count in blood CP, ESR (erythrocyte sedimentation rate), C-reactive protein test, MRI and ultrasound. If signs of GCA are also present then biopsy of temporal artery is done for the diagnosis.

Polymyalgia rheumatica complications: Polymyalgia rheumatica is rarely associated with complications as it is a self limiting disease and with proper treatment this disease can be managed in maximum three years. Polymyalgia rheumatica complications, rather rare, usually arise due to accelerated atherosclerosis associated with uncontrolled systemic inflammation and can lead to mortality.

Polymyalgia rheumatica treatment: Usually corticosteroid therapy is recommended to bring done inflammation which seems to be the main cause of the symptoms but it is associated with several side-effects such as steroid psychosis, anxiety   , depression,  hypertension, muscle wasting, hyperglycemia, steroid induced osteoporosis, peptic ulcer, cataract and retinopathies. Polymyalgia rheumatica herbal product is the best available polymyalgia rheumatica treatment as it relieves symptoms earlier and is not associated with any complications. Polymyalgia rheumatica herbal product is even safe for use during pregnancy.

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