Polymyalgia Rheumatica 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.
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.
Polymyalgia rheumatica questions
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
September 2007. 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.