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Friendly Print preview ARTHRITIS
FOUNDATION OF VICTORIA POLYMYALGIA RHEUMATICA .. Polymyalgia rheumatica is a condition involving muscles which can affect middle aged or older people, causing pain and stiffness in the neck, shoulder and hip regions. Onset may be quite sudden; at other times it will be gradual. Stiffness is usually the main problem; it is worse after rest and can sometimes make it difficult to get out of bed in the morning. The average age of those developing the condition is about 70 years, and women are twice as likely to be affected as men. While the disease is unusual, it is by no means rare. One in several hundred people is likely to experience it. Most people with polymyalgia rheumatica also have a fever and complain of fatigue. Sometimes loss of appetite and weight loss occur. Investigations ordered by the doctor show a raised ESR (Erythrocyte Sedimentation Rate - a measure of inflammation). Corticosteroid drugs (in this case prednisolone) are used to treat the inflammation of polymyalgia rheumatica, starting with a moderate dose to control symptoms, and reducing it as quickly as possible. Treatment may be stopped altogether after two or more years. Prenisolone has a dramatic effect on the stiffness and aching, and allows the person to carry out normal daily activities. Fortunately the disease does burn itself out over time. Most people are able to cease medication within four to five years. Whilst there is some good news associated with polymyalgia rheumatica, there is a potentially dangerous complication called giant cell arteritis. This is an inflammation of blood vessels, including those which supply the eye. The worry is that irreversible blindness can occur. There are also recent suggestions of an increased death rate from heart and blood vessel damage among people who have been inadequately treated. Anyone over 50 who experiences severe headaches which are localised to the temple and may be accompanied by a tender scalp, problems with vision, or stiffness and aching in the muscles must see a doctor immediately. Giant cell arteritis is completely treatable. Corticosteroids are used, usually in higher dosages than for polymyalgia rheumatica in recognition of the potentially serious consequences. The dosage is tapered off carefully to prevent possible relapses and the medication can eventually be stopped. Jenny Davidson, former Manager Education and
Services, From Arthritis Update, Autumn 1995 Date Last Reviewed by NEVDGP: 20 August, 2006
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