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POLYMYALGIA RHEUMATICA: A DISEASE OF THE ELDERLY

Polymyalgia Rheumatica (PMR) is a chronic inflammatory disease that causes muscle stiffness and pain, typically of the hips and shoulders. The etiology of PMR is not defined but is perceived to be an autoimmune disease, as a result of the inflammatory mediators working against the own healthy tissues of the body. Environmental exposure and genetics have also got a role to play in its development.

The prognosis of PMR is excellent is if diagnosed correctly. You need an Orthopedic Doctor in Lahore on board if you want to avert the debilitating complications of this condition. You must visit them now!

RISK FACTORS: HOW DO I KNOW IF I AM SUSCEPTIBLE?

The incidence of PMR tends to increase with age. Age group > 50 until 80 years is more susceptible to developing this disease. As per the Mayo Clinic’s research, women are two to three times more likely to be affected by this disorder. Smoking, sun exposure, and certain infections are some of the other common risk factors for this condition.

CLINICAL FEATURES: WHAT DOES PMR LOOK LIKE

PMR is characterized by a set of following clinical manifestations:

  • Aching and stiffness in the shoulders and the pelvic girdle. It may gradually spread to other parts as well and usually affect both sides of the body.
  • Rigidity is most apparent in the morning or after a period of inactivity and generally lasts longer than 30 minutes.
  • Weakness
  • Fatigue
  • Mild fever
  • Malaise
  • Weight loss
  • Anemia
  • Depression
  • Limited range of motion

Physical examination may reveal findings like:

  • Diffuse tenderness across the shoulders. The pain can restrict the shoulder’s active range of motion while the passive range of motion can remain unaffected.
  • Reduced neck and hip movement along with complaints of muscle tenderness.
  • Affected flexibility of joint and range of motion. A classic PMR finding is an inability to actively abduct the shoulders more than 90 degrees.
  • Tenderness typically felt upon palpation.
  • Altered muscle strength, tone, or function on motor examination.

COMPLICATIONS: WHY I NEED NOT BE IGNORANT

Polymyalgia rheumatica can be a debilitating disease if it remains untreated. Persistent pain and stiffness in the muscles can severely affect the function of the musculoskeletal system. This eventually leads to reduced mobility and an extremely restricted range of motion insufficient to perform everyday activities as well.

Tasks as simple as getting out of bed or getting dressed become painful jobs. Some patients may have a temporary loss of joint control too. This raises the likelihood of chronic joint problems such as a frozen shoulder.

TREATMENT: WHAT CAN MAKE MY CONDITION BETTER?

PMR has a purely symptomatic treatment. It focuses on alleviating pain and inflammation and relieving stiffness and malaise using corticosteroid therapy. Prednisone is a drug of choice for PMR. Low-dose therapy is extremely effective in resolving the symptoms and restoring the previous musculoskeletal function.

Mild cases of PMR can occasionally be treated with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. However, often NSAIDs alone can turn out to be ineffective hence they may be used in combination with the corticosteroid maintenance dose. This helps lessen the excessive use corticosteroid as its prolonged use generally results in adverse events such as osteoporosis, diabetes mellitus, hypertension, etc.

The doctor might even prescribe Vitamin D and Calcium supplements alongside to mitigate the risk of any side effects during treatment. Supplements are often recommended if you are taking corticosteroids for more than three months.

As much as the medication is important, it is equally imperative for PMR patients to incorporate exercise and/or physiotherapy, under professional surveillance, into their daily routine. A regular physical routine reinforces muscle tone and function, and joint flexibility. A diet of fruits, vegetables, and low-fat meat and dairy products is greatly advised to maintain good health.

Compliance with a low-dose corticosteroid therapy as per prescription yields dramatically improved results. Keep up with regular visits to Dr. Altaf Hussain Shah in Islamabad to see yourself improving each day!

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