Polymyalgia Rheumatica Responds to Prednisone

Q: I am 80 years old, and about a year ago was diagnosed with Polymyalgia Rheumatica. At that time I was told little or nothing about the disease. Any information I have, has been obtained through the Mayo Clinic Family Health book.

I would appreciate it if you could give me some additional information on alternative treatment. Is there a time period for it to last, and what I can do to help myself? Exercise is very painful, as this problem affects my hands, shoulders, legs and back.

Q:Several months ago I was diagnosed with Polymyalgia Rheumatica. I did get a brochure from my rheumatologist but really would like to know much more about this disease. There is lots of information about fibromyalgia but next to nothing about "Poly." What can you tell me or where can I find out more? I tried at the library but don't know how to use the computer. I am 73-years-old and otherwise in pretty good shape.

A:Polymyalgia rheumatica (PMR) is a disease of older people, as you can guess from the ages of the two readers above. It rarely occurs before the age of 50 and most patients are older than 60 when diagnosed. Pain and stiffness in the neck, shoulders, upper arms, lower back and thighs are the symptoms, and most of the time PMR involves both sides of the body. Patients often feel the worst in the morning and have a hard time getting out of bed or if they sit in one position for a long time. Although the symptoms may mimic rheumatoid arthritis, the good news is that the joints are not destroyed.

PMR responds rapidly to a low dose of prednisone (a steroid), about 10-20 mg a day. Later on, this dose can usually be tapered down to 5 to 7.5 mg a day. Some patients can discontinue taking prednisone after a year or two, but about 1/3 of patients will require prolonged treatment. In patients who have stopped prednisone, they may feel well for months or years before having another "flare" of PMR. The recurrence of disease will also respond to treatment with prednisone again.

I do not know of any "alternative" treatment that is effective for PMR. Both of you should stay as active as possible. I think water aerobics are excellent for people with musculoskeletal pain. The water is soothing and doesn't put stress on your joints.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.