Rheumatoid polymyalgia is a chronic and inflammatory condition of unknown origin that occurs relatively frequently in people over 50 years of age. It is characterized by the appearance of predominantly nocturnal pain, which is not attenuated with commonly used analgesics.
Although there is no specific diagnostic method, doctors often request some laboratory tests to rule out other more common conditions. In any case, therapeutic options are effective in the majority of patients, which allows a good reestablishment of their quality of life. Are you interested in knowing more about it?
Symptoms of rheumatoid polymyalgia
Rheumatoid polymyalgia is characterized by the presence of muscular pain located at the level of the scapulae, hip and neck. This sensation is often associated with joint stiffness, and symptoms worsen as the day progresses. For this reason, at night it usually causes difficulty sleeping and performing daily activities.
The onset of symptoms is progressive, while the age of presentation is from 50 years. According to a study published in 2015, the incidence increases between 70 and 80 years of age, and is more common in people of Nordic origin.
A significant proportion of patients present concomitantly with a condition called “giant cell arteritis.” It is an inflammatory condition of the blood vessels that can cause headaches, fever and visual problems, according to a publication from the Mayo Clinic.
Possible causes of polymyalgia rheumatoid
The only thing that is known with certainty about the origin of polymyalgia rheumatoid is that it is an inflammatory disorder. For the rest, it has an unknown origin. There are many theories about its causes, such as the presence of defective genes related to the proper functioning of the immune system.
It is also thought that a previous infection with some microorganisms, such as Mycoplasma pneumoniae and Chlamydia pneumoniae, can trigger the disease many years later. In any case, the scientific evidence supporting these theories is still scant.
There are some people who are at higher risk of developing the disease in the future. Some of the most important risk factors identified so far are the following:
- Advanced age: as we have already mentioned, from the age of 50 the incidence of the disease increases a lot.
- Family history: this means the presence of direct relatives with polymyalgia rheumatoid.
- Female sex: Like many other rheumatologic disorders, women are at increased risk of the disease.
There is no specific laboratory study to diagnose polymyalgia rheumatoid. Doctors often use a combination of clinical and paraclinical elements to diagnose it , which also make it possible to rule out other more frequent diseases. Some of the studies that could be requested are the following:
- Complete blood count.
- Blood chemistry.
- Rheumatoid factor.
- Erythrocyte sedimentation rate (ESR).
- C-reactive protein (CRP).
While rheumatoid factor is often negative – and sometimes positive in other conditions such as rheumatoid arthritis – the last two studies are often flawed. These are collectively known as “acute phase reactants,” and their concentration is increased in inflammatory processes such as rheumatoid polymyalgia.
Occasionally, some radiographic studies may be requested to verify that there are no associated bone or joint lesions. Given its similarity to many diseases, doctors may perform other studies to rule out other conditions. Some of these are rheumatoid arthritis, systemic lupus erythematosus, and other types of arthritis.
Fortunately, most patients respond satisfactorily to treatment. The main drugs used are from the group of corticosteroids, whose main effect is immunosuppression (decreased activity of the immune system).
These are usually given for a long period of time – even up to a year – so patients must constantly go to the doctor. These can cause various side effects, such as adrenal gland failure when treatment is abruptly stopped.
Possible complications of polymyalgia rheumatoid
Do you remember that at the beginning of this article we talked about the association of this disease with giant cell arteritis? This aspect is important because it explains the cardiovascular complications that these patients usually suffer.
When they are not receiving treatment, the incidence of peripheral arterial disease and myocardial infarction increases dramatically. So far it is not known exactly whether the aforementioned arteritis is a cause or consequence of polymyalgia rheumatoid; but, ultimately, it is no coincidence.
With timely treatment everything should improve
In general, it is a pathology with a good prognosis. Although treatment is lengthy and associated with many adverse effects, the benefits outweigh the potential risks.
In case of presenting any of the symptoms, it is necessary to go to the doctor as soon as possible . The most appropriate thing is that the latter be a specialist in rheumatology.