Polymyalgia rheumatica (PMR), which literally means many aching muscles, is an inflammatory disorder of the muscles and joints characterized by pain and stiffness, affecting both sides of the body, and involving the shoulders, arms, neck, and buttock areas. Patients with polymyalgia rheumatica are typically over the age of 50 years and it affects almost half a million people in the UK, with women being more likely to be affected than men.
The onset of polymyalgia rheumatica can be abrupt, or it can creep up slowly over a few weeks. If you have polymyalgia rheumatica you will most likely have muscle pains, sometimes quite sudden and severe, in your shoulders, neck and upper arms and also in your hips and upper legs. You may find that morning stiffness is a problem, to the extent that you may need help in getting out of bed.
You could also have other symptoms, such as lethargy, depression, weight loss and fever. The disease often goes away without treatment after a year or so, although few people have the patience to put up with the symptoms for that long!
The symptoms of polymyalgia rheumatica may at first appear similar to those of other inflammatory illnesses, such as rheumatoid arthritis, fibromyalgia and lupus. In fact, polymyalgia rheumatica has only been recognised as a distinct disease since 1969. Your doctor may need to carry out several tests before a diagnosis of polymyalgia rheumatica can be made, although there is no single specific test for the disease.
Although the underlying cause of polymyalgia rheumatica is unknown, it has been suggested that it is an autoimmune disease, in which the body is attacked by its own immune system. It also appears to be linked to another inflammatory condition called giant cell arteritis (not to be confused with arthritis) that 10 to 15 per cent of polymyalgia rheumatica patients are also diagnosed with. Giant cellÂ is a disorder that results in swelling of arteries in the head. Most often the temporal arteries, which are located on the temples on each side of the head.
Conventional treatment for polymyalgia rheumatica is with steroid drugs, which themselves have many unpleasant side-effects and do nothing to cure the underlying problem. Luckily, some effective natural remedies are reported to provide welcome alternatives to drug treatment for sufferers of this nasty condition.
Polymyalgia rheumatica: Don’t risk steroid medication boost – your body’s own steroid hormones instead
The conventional treatment for polymyalgia rheumatica is the scattergun approach of steroid drugs the usual standby for any kind of acute inflammation. Your doctor will probably prescribe the powerful artificial steroid hormone Prednisone. This will certainly relieve the symptoms, often within a day or two, and may seem like a magic bullet. But long-term treatment with these drugs carries a number of serious risks, including weight gain, diabetes, glaucoma, cataracts and osteoporosis, so it makes sense to reduce the dose to the lowest needed to control the symptoms.
You may also be prescribed non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or diclofenac, to control the pain. But the effectiveness of NSAIDs tends to reduce with time and they can cause digestive problems, stomach bleeding and nausea. They have also recently been linked to an increased risk of high blood pressure and heart disease (BMJ 2004;329: 1317-20).
You can help to reduce the amount of steroid medication you need by making sure that your body’s own steroid hormones, which are made by your adrenal glands, are being produced efficiently. The first step is to cut out things that put the most stress on your adrenals sugar, caffeine (found in coffee, tea and cola) and nicotine. The next step is to attempt to boost your own steroid hormone production.
Pantethine, which is manufactured in the body from vitamin B5, is essential for the proper functioning of the adrenal glands and for the production of natural steroids, called glucocorticoids.
Boosting your own production of steroids can help bring the same benefits for relieving polymyalgia rheumatica as taking artificial steroid drugs, but without the harmful side effects. Pantethine also increases the levels of essential omega-3 fatty acids in the body, which also reduce inflammation (Int J Clin Pharm Res 1985;5(5): 309-18).
The recommended dose of pantethine is 600 mg a day. Other nutrients that provide your adrenal glands with the raw materials to produce natural steroid hormones are vitamin C (1-2 g a day), vitamin B6 (50-100 mg a day as part of a B-complex supplement) and vitamin A (12,500- 25,000 IU a day, but avoid in pregnancy).
Polymyalgia rheumatica: These natural anti-inflammatories can reduce your reliance on drug treatment
It is believed that natural anti-inflammatory compounds in herbal remedies and food supplements can also help you reduce your reliance on medication, and so reduce the risk of harmful side-effects. As mentioned above, essential fatty acids such as omega-3 found in oily fish, have a good record of reducing inflammation, decreasing pain and increasing the ease of movement (Atherosclerosis 1990;81: 209-16).
The omega-6 essential fatty acid gamma linolenic acid (GLA), found in evening primrose oil capsules and borage oil capsules, can also reduce morning stiffness, and is frequently of help in PMR (Cl Immunol Immunopathol 1997;83(3); 237-44). Try ingesting 3,000 mg of omega-3 fatty acids and 1,500 mg of omega-6 fatty acids daily.
Bromelain, an enzyme derived from the pineapple plant could hold promise for PMR sufferers. Although most research with this enzyme has involved people with rheumatoid arthritis, its ability to reduce inflammation could be just as valuable to those with polymyalgia rheumatica.
In a trial involving 25 patients with severe RA, an enteric-coated bromelain supplement substantially reduced joint swelling and inflammation. Whats more, most patients were able to taper off their steroid medication to small maintenance doses (Penn Med J 1964;67: 27-30). Take 600 mg of bromelain a day, on an empty stomach.
Methyl-sulphonyl-methane, or MSM, is a natural sulphur compound produced in the body that is often used to control the pain and inflammation of arteries and is likely to be of benefit in PMR, too. In one six-week study, patients taking 2,250 mg of MSM a day reduced their joint pain by an amazing 82 per cent, compared with an 18 per cent improvement in those given a placebo (Int J Anti-Aging Med 1998;1(1): 50). The recommended dose is 1000 mg of MSM a day.
Supplements are not the only way you can help yourself to beat polymyalgia rheumatica. Also suggested to help polymyalgia rheumatica is regular gentle exercise, massage and electro-acupuncture. For more information on electro-acupuncture, please contact the Acupoint Herbalist Centre, 42 Goodge Street, London W1T 2QR, tel. 020 7436 9735.
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