Polymyalgia Rheumatica (PMR) is an autoimmune condition that causes widespread pain and stiffness, particularly around the shoulders and hips. It’s a condition that’s easily mistaken for other forms of arthritis, especially rheumatoid arthritis, but the appropriate treatment plan hinges on the correct diagnosis.
What Is Polymyalgia Rheumatica?
The name itself tells you quite a bit: poly means many, myalgia means muscle pain, and rheumatica relates to inflammation of the joints or connective tissues. PMR causes pain and stiffness on both sides of the body, especially first thing in the morning or after periods of rest. The shoulders and hips are the most commonly affected areas, but the neck and upper arms can also feel sore and heavy.
PMR tends to affect people over the age of 50, and is more common in women. The exact cause is yet unknown, but it likely involves genetic factors, and immune system reactions, potentially to something simple like an infection. Osteopaths are trained to spot the signs of rheumatological conditions like these. The symmetrical pattern of pain, which is worse after rest, is a flag that we should send you on to your GP.
The Link Between PMR and Giant Cell Arteritis
Around 20% of people with PMR also develop GCA or Temporal Arteritis. This is an inflammation of the arteries around the temples, which supply the eyes and brain. It is manageable, but needs prompt diagnosis. If you notice a new headache (which may throb), scalp pain or pain on chewing, speak to your GP. Visual changes should also be noted quickly.
Medication for PMR
PMR is usually managed via your doctor with a course of steroids. Many people notice improvement within days or weeks, though it can take longer. Once symptoms improve, the dosage is tapered down. Some people need to stay on a low dose for a year or so, but ideally steroid use would be as limited as possible to minimise complications like osteoporosis.
Osteopathy and PMR
Osteopathy can help to manage the secondary symptoms of PMR. Where joints are irritated, the local muscles will often tighten up to try and protect the area. In reality, we need more movement here, not less, and restriction leads to compensation from other structures. This pattern of tension can continue even when the inflammation is manged. Alongside the work your GP or rheumatologist is doing, your osteopath can help to keep you comfortable and prevent the development of additional aches and pains.
When your symptoms begin to subside, we can move into the next stage of the treatment plan: maintaining strength and flexibility to improve your resilience and hopefully minimise the impact of another flare. We can also help you to spot the signs of a developing flare so you can get timely treatment as needed.
You might find yourself making an osteopathy appointment even when your PMR is under control, due to these patterns of tension. Tight buttock muscles are common with the hip pain PMR brings, and that in turn can cause piriformis syndrome (a form of sciatica). Your osteopath will take a thorough history and can draw the link between the two issues to build up a comprehensive view of your problems.
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