Polymyalgia Rheumatica

The cause of polymyalgia rheumatica is not exactly known. However two factors are considered to be involved in the occurrence of this condition:

• Genetics: Some genes and gene variations can elevate the risk of this disease.
• Environmental exposure: As the new cases of polymyalgia rheumatica likely to come in cycles and can occur seasonally therefore it is suggested that an environmental trigger as a virus may play a role.

• Giant cell arteritis: Polymyalgia rheumatica and the disease called as giant cell arteritis have many similarities. Giant cell arteritis leads to in inflammation in the lining of arteries. Giant cell arteritis may cause scalp tenderness, headaches, jaw pain and vision problems. If it is left untreated, it may result to stroke or blindness.

  Polymyalgia rheumatica and giant cell arteritis can be the same disorder but with dissimilar sign. About 20 percent of the patients of polymyalgia rheumatica have signs and symptoms of giant cell arteritis also. About half of the patients of giant cell arteritis may suffer from polymyalgia rheumatica.

The risk factors for polymyalgia rheumatica include:

• Age: Older people are affected by Polymyalgia rheumatica almost exclusively. The average age at the beginning of this disease is 73 years.
• Gender: Women are about twice more susceptible to develop the diseases.
• Race and geographic region: Polymyalgia rheumatica is the commonest among whites in northern European people.

The signs and symptoms of polymyalgia rheumatica generally develop on both the sides of body. They may include:

• Aches in shoulders
• Aches in buttocks, neck, upper arms, hips or thighs
• Stiffness in the affected areas, especially in the morning or after inactivity for a long time
• Inadequate range of motion in the affected areas
• Stiffness or pain in wrists, knees and elbows

You may also suffer some of the common signs and symptoms as:

• mild fever
• malaise
• fatigue
• reduced appetite
• unwished weight loss
• depression

Physical examination can help the doctor to determine the cause of pain and stiffness. According to studies 2 to 30 percent of patients of polymyalgia rheumatica were later diagnosed to have rheumatoid arthritis. Your doctor will perform an exam to check your overall health. He or she may also gently move your limbs and head to detect if your symptoms affect the range of motion in you. he or she may recommend you following tests:

• Blood tests: A blood sample is used for many laboratory tests which doctor orders. Your doctor will determine the complete blood counts and erythrocyte sedimentation rate and C-reactive protein.
• Imaging tests: Ultrasound is to differentiate between the polymyalgia rheumatica from other conditions that show same symptoms. Magnetic resonance imaging (MRI) may also reveal the other reasons of shoulder pain.

Treatment for Polymyalgia rheumatica involves medicines that ease the symptoms are as follows:

Corticosteroids

Polymyalgia rheumatica is commonly treated with small dose of an oral corticosteroid. The beginning of treatment is generally 12 to 25 mg per day. You will get relief from the stiffness and pain within the two or three days. In case you are not getting relief with the treatment then your doctor will refer you to rheumatologist.

After the two to four weeks doctor can start decreasing your dosage based on your symptoms and the blood tests. Many people with polymyalgia rheumatica require continuing the corticosteroid treatment for a year at least. Such people need to visit doctor frequently to monitor if you are having any adverse effects.

Physical Therapy

Patient of Polymyalgia rheumatica can get benefit from physical therapy. You can talk to your doctor regarding the physical therapy which is a good option for you in case you want to regain strength, coordination and the ability to do everyday tasks.

Alternative Medicines

• Ayurvedic Medicines: Shallaki (Boswellia serrata), Tagar (Valeriana wallichii), Guggulu (Commiphora mukul), Nirgundi (Vitex negundo), Vishwa (Zinziber officinalis), Rasna (Pluchea lanceolata), Chitrak (Plumbago zeylanica) and Punarnava (Boerhaavia diffusa) are the some of the herbal medicines used in the treatment of Polymyalgia rheumatica.
• Kairali Massage: Vishgarbha oil, Mahamash oil, Mahanarayan oil and Mahasaindhav oil are the commonly used Ayurvedic oils for massage in the condition of Polymyalgia rheumatica.

Dietary Supplement for Polymyalgia Rheumatica

Dietary supplements include products containing minerals, herbs, vitamins, and many other elements that have a huge role in the maintenance of health. They come as drinks, pills, energy bars, capsules, and powders.

GLME (Green Lipped Mussel Extract): GLME is the most recommended dietary supplement for polymyalgia rheumatica. It is extracted from the green lipped mussels. Green lipped mussel is a shell fish grown in the farms of New Zealand.

GLME (Green lipped mussel extract) has unique role in the treatment and management of Polymyalgia rheumatica because:

• It controls the process of inflammation through several mechanisms and thus reduces swelling, pain, and inflammation.
• It helps other medicines to show their maximum efficacy.

Seatone is the best preparation of GLME because:

• It is extracted from the premium quality of fresh mussels at their peak condition. Their harvesting is done at the best times of year.
• A number of tests are conducted to check the toxicity of Seatone. Seatone is made available to you after several tests and trials.

Seatone is better than all the other treatments for arthritis because:

• Seatone does not show any side effects. While the corticosteroids used in the treatment of Polymyalgia rheumatica show side effects on prolonged use.
• Seatone provides permanent relief which may be slow.
• Seatone do not show side effects even at higher doses while corticosteroids show numerous side effects at higher doses.

Over-the-counter Nonsteroidal anti-inflammatory drugs as ibuprofen or naproxen are not generally advised for relieving the signs and symptoms of polymyalgia rheumatica. But healthy lifestyle can help you to manage the adverse effects which can occur due to corticosteroid treatment:

• Eat healthy food: Eat a diet of whole grains, fruits, vegetables and dairy products and low-fat meat. You should limit the salt in your diet to avoid high blood pressure and fluid buildup.
• Exercise regularly: you can take the help of your doctor to know about the exercise which is appropriate for you so as to strengthen bones and muscles and to maintain a healthy weight.
• Use assistive devices: Use grocery carts, shower grab bars, reaching aids and other assistive devices to make daily tasks easy. Talk with your doctor about the use of a cane or other walking aids to prevent falls.

Polymyalgia rheumatica cannot be prevented. However focus is made to prevent the side effects of drugs used in its treatment.

The prognosis of the patients with isolated polymyalgia rheumatica is very good. For successful treatment of polymyalgia rheumatica it should be gradual and not rapid, reduction of the medication. This will prevent the unwanted flare-ups of the disorder.

Patients should take vitamin D and calcium supplements because the prednisone and prednisolone can cause potential bone toxicity, leading to osteoporosis. Bone mineral density testing should be done in the patients and doctors can consider recommending osteoporosis medications as estrogen and risedronate for it.