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Treatments and drugs
By Mayo Clinic staff
Corticosteroids
Polymyalgia rheumatica is usually treated with a low dose of an oral corticosteroid, such as prednisone. A daily dose at the beginning of the treatment is usually 10 to 20 milligrams a day.
Relief from pain and stiffness should occur within the first two or three days. If you're not feeling better in a few days, it's likely you don't have polymyalgia rheumatica. In fact, your response to medication is one way your doctor can confirm the diagnosis.
After the first two to four weeks of treatment, your doctor will gradually decrease your dosage depending on your symptoms and the results of sed rate and C-reactive protein tests. The goal is to keep you on as low a dose as possible. Most people with polymyalgia rheumatica need to continue the corticosteroid treatment for two to three years.
You will have frequent follow-up visits to monitor the treatment effect and assess for possible side effects.
Monitoring side effects
Long-term use of corticosteroids can result in a number of serious side effects. Your doctor will monitor you closely for potential problems. He or she may adjust your dosage and prescribe treatments to manage these reactions to corticosteroid treatment. Side effects include:
- Osteoporosis, the loss of bone density and weakening of bones, which increase the risk of bone fractures
- High blood pressure (hypertension), which increases the risk of cardiovascular disease
- High cholesterol, which also increases the risk of cardiovascular disease
- Diabetes, chronic high levels of blood sugar that can cause tissue damage in a number of body systems
- Cataracts, a clouding of the lenses of your eyes that can significantly impair your vision
- Depression or other disturbances in your emotional well-being
Calcium and vitamin D supplements
Your doctor will likely prescribe daily doses of calcium and vitamin D supplements to help prevent osteoporosis induced by corticosteroid treatment. The American Academy of Rheumatology recommends, at a minimum, the following daily doses for anyone taking corticosteroids for more than three months:
- 1,000 to 1,200 milligrams (mg) of calcium supplements
- Up to 1,000 international units (IUs) of vitamin D supplements
Physical therapy
Your doctor may recommend physical therapy to help you regain strength, coordination and your ability to perform everyday tasks after a long period of limited activity that polymyalgia rheumatica often causes.
- Michet CJ, et al. Polymyalgia rheumatica. BMJ. 2008;336:765.
- Unwin B, et al. Polymyalgia rheumatica and giant cell arteritis. American Family Physician. 2006;74:1547.
- Polymyalgia rheumatica. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/polymyalgiarheumatica.asp. Accessed April 14, 2010.
- Polymyalgia rheumatica. The Merck Manuals: The Merck Manual of Healthcare Professionals. http://www.merck.com/mmpe/sec04/ch033/ch033i.html. Accessed April 6, 2010.
- Salvarani C, et al. Polymyalgia rheumatica and giant-cell arteritis. Lancet. 2008;372:234.
- Giant cell arteritis. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/giantcellarteritis.asp. Accessed April 15, 2010.
- Glucocorticosteroid-induced osteoporosis. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gi-osteoporosis.asp. Accessed April 15, 2010.
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