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Diagnosing Polymyalgia rheumatica

Diagnosing Polymyalgia rheumatica

The first thing to do after feeling pain and stiffness while doing daily life activities is to visit the house doctor or the rheumatologist. Daily activities include activities such as getting out of bed, standing up from a chair, getting out of the car, putting on a coat, shaving, brushing your teeth or combing your hair. Since the symptoms of polymyalgia rheumatica (PRM) are very similar to other illnesses, the doctor will conduct several tests including a physical exam to determine the overal health status and the cause of the pain and stiffness. Moreover, this diagnostic process helps the doctor discard other disorders that have similar symptoms to PRM. Further, the diagnosis may be reassessed as the treatment progresses due to the significant simmilarity between for example polymyalgia rheumatica and rheumatoid arthritis. Studies reveal that up to 30% of the people having rheumatoid arthritis were initially diagnosed with polymyalgia rheumatica.

As mentioned above, there are several tests conducted by the doctor to diagnose PMR such as a physical exam, blood tests, imaging tests and the monitoring for giant cell arteritis test.

Physical exam: This exam is very simple and implies the gently movement of head and limbs by the doctor to assess whether the symptoms affect the range of motion.

Blood tests:

First, the patient will give a sample of blood, which will be used for several laboratory tests such as a check of the complete blood counts (CBC) and two indicators of inflammation — sed rate (erythrocyte sedimentation rate) and C-reactive protein. In PMR, results of blood tests to detect inflammation are most often excessively high but, in some patients, these tests may have normal or only slightly high results. For this reason is polymyalgia rheumatica hard to diagnose. Further tests are needed to discard other diseases, which have very similar symptoms to PMR.

Imaging tests :

An ultrasound will be used to differentiate polymyalgia rheumatica from other illnesses, which have simmilar symptoms. Further, a magnetic resonance imaging (MRI) can also help identifying other causes of e.g. shoulder pain such as degenerative joint changes.

Monitoring for giant cell arteritis test:

The patient must immediately inform the doctor in case of having one or more of giant cell arteritis symptoms such as:

  • New, unusual or persistent headaches

  • Jaw pain or tenderness

  • Blurred or double vision or visual loss

  • Scalp tenderness

During the diagnosis process it is important to take any medication the doctor has given to release the pain. Please keep in mind that Nonsteroidal anti-inflammatory drugs (commonly called NSAIDs), such as ibuprofen (or similars such as paracetamol) and naproxen (anti-inflammatories) are not effective in treating PMR and therefore they are not usually recommended for easing pains caused by polyamyalgia rheumatica. In any case, there are some steps that every patient can follow besides taking the medicines given by the doctor:

  • The most important thing to do is to eat a healthy balanced diet, which includes fruits, vegetables, whole grains, and low-fat meat and dairy products. A low consumption of salt is highly recommended in the diet in order to prevent fluid buildup and high blood pressure.

  • Regular exercise has always been very helpful in order to maintain a healthy weight and to strengthen bones and muscles. The doctor can specifically recommend the most appropriate exercises for each specific condition.

  • The use of assistive devices such as a cane or other walking aids may also be helpful if the doctor recommends them. In any case using luggage and grocery carts, reaching aids, shower grab bars and other simmilar assistive devices are always helpful to make daily tasks easier.