Polymyalgia is a pain

October 27, 2010 By

DEAR DR. GOTT: My doctor diagnosed me with polymyalgia. I have pain in the back of my head, shoulders and lower back that usually occurs at night and goes away when I get up in the morning. I’m 78 years old, in generally good health with no diabetes, heart or other problems. I go to physical therapy three times a week for my back problem and have traction treatment as well, which seems to be working. Is there any help for me?

DEAR READER: Polymyalgia rheumatica (PMR) is an inflammatory disorder that results in widespread muscle aches, pains and stiffness of the hips, shoulders, thighs, upper arms and neck, fatigue, anemia, malaise and unintentional weight loss. Symptoms experienced are the result of mild inflammation of the joints and surrounding tissue. Stiffness can worsen following periods of inactivity, such as after a night’s sleep or sitting for too long.
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Differentiating between fibromyalgia and polymyalgia

February 18, 2010 By

DEAR DR. GOTT: I recently read in one of your newsletters about fibromyalgia. I have polymyalgia. Could you please explain the difference between the two and what medication I should be using? I would appreciate hearing from you.
DEAR READER: Fibromyalgia is a disorder characterized by widespread pain of muscles and ligaments, coupled with a painful response to even gentle touch. The symptoms may wax and wane and can be vague. Women are more prone to the disorder and typically experience pain throughout the entire body. Men, on the other hand, often report facial pain or discomfort in a specific part of the body. This is often a diagnosis of exclusion, because so many symptoms mimic other disorders, making it difficult for a physician to diagnose. [Read more...]

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Wean slowly off Prednisone

April 10, 2008 By

DEAR DR. GOTT:
I have been taking prednisone 10 mg daily for 14 months for PMR. I cannot take less than 8 mg without a lot of pain in my wrists and hands. I have researched this and discussed my concerns with my rheumatologist who has now put me on methotrexate (4 tablets of 2.5 mg once a week) to try to wean me off the prednisone. Is this the lesser of two evils? I worry about the long-term side effects of both medicines and more importantly, how to cure the PMR. Any suggestions?

DEAR READER:
Polymyalgia rheumatica is an autoimmune disorder that causes muscle pain and stiffness in joint areas. Relief is achieved by reducing inflammation with over-the-counter medications or, in severe cases, with oral steroids as the mainstay of treatment. PMR can be a disabling disorder requiring aggressive therapy in an attempt to reduce the body’s immune response. Unfortunately, the treatment is not without risk.

You apparently have progressed from over-the-counters to prescription medications, and I cannot advise you which drug to take. That decision depends on your response to each medication. Methotrexate is, in my experience, less troublesome than prednisonebut still has its own side effects.

Although some PMR patients suddenly improve after many years, PMR typically is permanent and incurable. Therapy to treat symptoms is extremely effective but must be taken for years.

I believe that you are in good hands; your rheumatologist has made sound decisions thus far. I urge you to stick with the recommendations provided. Periodically review your health issues with him or her and try to get by on the smallest amount of medication that controls your pain.

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