Polymyalgia Rheumatica natural treatment, alternative
therapy, supplements herbs vitamins that may benefit
January 20 2017 by Ray Sahelian, M.D.
Polymyalgia rheumatica (PMR) is a relatively chronic, episodic, inflammatory disease of the large arteries and a common cause of widespread aching and stiffness in older adults. About one in 200 adults over the age of 50 have PMR.
Polymyalgia Rheumatica treatment
The beneficial effects of corticosteroid therapy in the treatment of rheumatic diseases may be offset by the occurrence of corticosteroid-related osteoporosis.
Rheum Dis Clin North Am. 2016. Glucocorticoids for Management of Polymyalgia Rheumatica and Giant Cell Arteritis. Glucocorticoids are the primary therapy for PMR and GCA. Methotrexate may be used in patients at high risk for glucocorticoid adverse effects and patients with frequent relapse or needing protracted therapy. Other therapeutic approaches including interleukin 6 antagonists are under evaluation.
Ther Adv Musculoskelet Dis. 2014. Advances and challenges in the diagnosis and treatment of polymyalgia rheumatica. Markers of inflammation are often elevated. Clinicians are often faced with the challenge of distinguishing PMR from other conditions, particularly rheumatoid arthritis and spondyloarthropathy that can mimic symptoms of PMR in older people. Additionally, there is an association between PMR and giant cell arteritis, a common large-vessel vasculitis which also affects people over the age of 50 years. Imaging of the large vessels in asymptomatic patients with PMR often reveals findings of subclinical vasculitis. Presently, there are no tests that are specific for the diagnosis of PMR and clinicians rely on a combination of history, physical examination, laboratory tests and imaging studies to make a diagnosis. A recent undertaking by the European League Against Rheumatism/American College of Rheumatology has led to the publication of provisional classification criteria of PMR. Ultrasonography, which is being increasingly used by rheumatologists, can greatly aid in the diagnosis of PMR and often shows changes of synovitis and tenosynovitis. Treatment consists of low doses of glucocorticoids which are associated with morbidity. Evaluation of newer biologic therapies targeting inflammatory cytokines is underway. Despite treatment, relapses are common.
Postgrad Med J. 2013. Diagnosis and management of giant cell arteritis and polymyalgia rheumatica: challenges, controversies and practical tips. Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are inflammatory rheumatic diseases that may present to a variety of disciplines and specialities. The mainstay of treatment is glucocorticoids (steroids); together PMR and GCA now represent one of the most common reasons for medium-to-high dose, long-term glucocorticoid treatment in primary care. However, adverse effects of glucocorticoids are common in these patients. Management of both diseases involves balancing the symptoms and risks of the disease against the adverse effects and risks of glucocorticoids. The crucial first step in management is to make a firm, well-documented diagnosis, since once glucocorticoids are started they can mask the symptoms of a number of other diseases. Diagnosis however can be challenging and there are still substantial gaps in the evidence for treatment.
Polymyalgia rheumatica symptoms
Symptoms of polymyalgia rheumatica are aching and stiffness, worst on arising in the morning, affecting the upper arms, neck, shoulder girdle, pelvic girdle, buttocks, and thighs. Symptoms usually respond promptly and completely to low doses of corticosteroids.
Complications of polymyalgia rheumatica
PMR may be the first manifestation of giant cell arteritis. Polymyalgia rheumatica may be the initial presentation of other rheumatologic diseases such as rheumatoid arthritis, spondyloarthropathy, systemic lupus erythematosus, myopathy, vasculitis, and chondrocalcinosis. Polymyalgia rheumatica may be the first manifestation of an endocrine disorder, a malignancy, or an infection.
Q. Have you any experience or an opinion on taking DHEA to help reduce the reliance on prednisone for people with polymyalgia rheumatica? Are there any nutritional supplements that would help?
A. Patients with polymyalgia rheumatica with new-onset active disease before steroid treatment have normal cortisol levels regarding the ongoing inflammation, and lower levels of DHEAS compared to the age- and sex-matched healthy control subjects. Whether taking DHEA is helpful in this condition is not clear since we can't find any human studies as of 2015. As to the nutritional approach to PMR, I don't have much clinical experience, but it would be worth trying a low inflammatory diet that consists of a large intake of a variety of vegetables, vegetable juices, and fish. Perhaps fish oil capsules would be helpful.
Q. Any herbs or supplements that will help with
polymyalgia rheumatica to stop taking steroids. Intense muscle inflammation.
A. I have not seen any specific research regarding the natural treatment of polymyalgia rheumatica with diet, herbs or supplements, but perhaps natural treatments that help rheumatoid arthritis may also help reduce the symptoms of polymyalgia rheumatica.
As a retired Holistic Practitioner I have been aware
of 5HTP for many decades and was thrilled to find Dr. Sahelian's website and
book. Now it is my turn to seek information for myself! I am taking 10 mg of
Prednisone for Polymyalgia Rheumatica and now in the 5th month of a possible 12
month regime. The side affects are horrific and my emotional state is -0 on the
Richter scale!!! Does 5HTP assist with "pharmaceutically induced" depression and
A. It may, but it is difficult to predict in any one individual what the benefits or side effects would be or what dosage is appropriate.
Thank you so much for your reply and for your truthfulness. I have actually been experiencing some significant relief, emotionally / psychologically, since starting 50 mg of 5HTP a few days ago. So, I will continue with the suggested regime and let the future unfold. I appreciate your comment. Knowing that we are all respond / react in an individual manner it is always interesting just to see how that tapestry of information unfolds. So far, following 5 days of 50 mg at night I am feeling grounded and less "volatile" and definitely less anxiety. I will maintain this regime for 2 weeks then start the 5 days on 2 days off and 1 week off a month. If your team come up with anything for what I am terming "pharmaceutically induced" depression from Prednisone I would be very interested in hearing from you.
I am a freelance journalist currently working on an article about home treatments for polymyalgia. I have three quick questions for you, if you don't mind taking the time to answer them. Do you specialize in alternative medicine? Is there a time when a person afflicted with polymyalgia should turn to more mainstream medicines for a cure? Which herb or supplement (or combination of supplements), has produced the best over all results in relieving the symptoms of polymyalgia?
I have Polymyalgia and have
been on prednisone for 10 years. Every time i lower my dose and try to get off I
sieze up and have unbearable pain so have to increase my dose again. The highest
is only 10 mg a day but I find that I amstill in quite a bit of pain with that
dose. I had a friend with polymyalgiaand she was able to get completely off her
prednisone with Wobenzym. Here is my problem. I had a heart attack two years ago
and am now on all these medications. I have two stents also. I want to take this
product but I am scared. My doctor and my cardiologist both retired in June and
I got anew doctor and am getting a new cardiologist. I feel alone and would
appreciate if you have any information on this.
A. I wish I could help but I have not seen any studies combining Wobenzym with medications.