$Unique_ID{BRK02059} $Pretitle{} $Title{Diagnosing and Treating Polymyalgia Rheumatica} $Subject{polymyalgia rheumatica arthritis pain cortisone shoulder shoulders hip hips joint aches ill stiff muscle muscles fever weight loss rheumatoid arthritis elevated sedimentation rate ESR corticosteroids prednisone aging} $Volume{} $Log{} Copyright (c) 1993 Tribune Media Services, Inc. Diagnosing and Treating Polymyalgia Rheumatica ------------------------------------------------------------------------------ QUESTION: After months suffering with a pain across her shoulders, my wife finally visited her doctor. What we both thought was simply a case of old age arthritis (she is now 73) was diagnosed as "polymyalgia rheumatica", a disease we have never heard about. The doctor wants to use cortisone, or some medication like that, but we are just a bit fearful. Could you please include a description of this disease and its treatment in your column? ------------------------------------------------------------------------------ ANSWER: Despite the fact that this is the first time you have heard about this disease, it is not an uncommon one. In people aged 70 to 79 years, it may be seen in as many as 112 people for every 100,000 population. More common in women than in men, it is rarely seen before the age of 50, and is often mistaken for arthritis. The pain usually starts either in the shoulder or hips, and these muscle and joint aches may last for months. The patient feels generally ill, stiff upon awakening, often with a fever. In some cases there is a weight loss as well. Occasional the pattern of joints that are affected greatly resembles the picture seen in rheumatoid arthritis. However x-rays of the joints are usually normal. About the only test that may help a doctor make the diagnosis is an elevated sedimentation rate (ESR), so a good history and physical is most important in arriving at the correct conclusion. The cause of this disease remains unknown, but the treatment is, and general consensus among medical experts agree that corticosteroids are the treatment of choice. Usually a dose of from 10 to 20 mg of prednisone daily is prescribed, and treatment may have to continue for more than 2 years. The good news is that, in most cases, the symptoms begin to disappear within a few days after treatment starts. The ESR also returns to normal, and the amount of medication can then be gradually reduced for as long as the symptoms do not return. Although relapses may occur, the treatment allows for return to a normal life style and a normal life expectancy. It seems apparent that your doctor has the right approach to this disease, and you should continue to follow his advice. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.