Polymyalgia rheumatica: symptoms, diagnosis, treatment

Tells Evgeny Zhilyaev,

Professor, MD, Doctor of the highest category.

Polymyalgia rheumatica (RM) is an inflammatory disease that manifests pain and stiffness in the muscle groups in the neck, shoulders and hips.

The causes leading to the development of the disease have not yet been established. However, polymyalgia rheumatica is often combined with another rheumatological disease from the group of vasculitis, giant cell arteritis. A number of authors consider these two diseases together as two forms of the same process. 

Symptoms of polymyalgia rheumatica

It is generally believed that this disease develops in people over the age of 50, mainly in women. The most common symptoms are persistent pain in the proximal (located closer to the trunk) muscles of the shoulders, hips and neck. The pain is especially pronounced in the morning after a prolonged lack of activity during a night's sleep. The joints themselves may swell and hurt. There are problems with self-care and movement (it is difficult to dress, comb your hair, get up from a sitting position, do basic household chores), which causes significant discomfort to the patient. Body temperature may rise, general weakness may appear, appetite may disappear and, as a result, body weight may decrease. Depression and anorexia can often develop with this disease.

Diagnosis of polymyalgia rheumatica

There is no single highly sensitive test that can accurately diagnose polymyalgia rheumatica. The diagnosis is established based on the patient's complaints, a significant increase in the rate of erythrocyte sedimentation and the content of c-reactive protein in the blood. Since these symptoms are not specific and can be observed in many other diseases, the doctor may recommend additional examination.

Treatment of polymyalgia rheumatica

The disease is characterized by a rapid response to the use of glucocorticoids (GK) in relatively small doses (12.5-20 mg prednisone). As the symptoms subside, the dose of HA gradually decreases. The average duration of treatment is from one to two years. In some cases, the disease recurs, which requires repeated administration or an increase in the dose of glucocorticoids. Therefore, adherence to treatment and strict adherence to the recommendations of the attending physician are of great importance.

Currently, there are cases of prescribing a number of other drugs, such as methotrexate, azathioprine, and tocilizumab, however, their advantages over the standard use of HA in mono- or combination therapy have not been proven. 

Advantages of the European Medical Center (EMC)

1. Outpatient follow-up by a rheumatologist at a therapeutic clinic, relief of symptoms and selection of optimal therapy. Professor Evgeny Valeryevich Zhilyaev, MD, is in the EMC rheumatology team.
2. EMC rheumatologists have their own scientific developments and significant practical experience in the field of polymyalgia rheumatic treatment.
Extensive diagnostic capabilities: a full range of instrumental and laboratory examination methods. Consultations with doctors of any specialties, if necessary.
3. A consultation of experts from related fields is organized to develop the best treatment tactics in difficult cases.
4. The possibility of hospitalization for examination and treatment in a comfortable EMC hospital with the possibility of round-the-clock visits by relatives and friends.
5. Urgent and emergency care at the clinic, call a doctor at home anywhere in Moscow and the Moscow region (up to 50 km from the MKAD).

Author: Evgeny Zhilyaev, Professor, MD, Doctor of the highest category.