Ask the Doctor: Sore Muscles Can Take Years to Recover

DEAR DR. DONOHUE: My mother has polymyalgia rheumatica. She is going through quite a bit - to the point where it’s hard for her to function. She is 74 and has always been healthy. We are under the impression it came out of nowhere and could last for two years.

Will you please give us your input on this disease? - C.M.

ANSWER: Sore, stiff shoulders, neck, lower back, hips and thighs are the hallmarks of polymyalgia rheumatica, an illness whose cause has yet to be discovered. It strikes people over the age of 50. Both sides of the body are affected, and that helps distinguish it from other muscle and joint problems.

Some patients experience fatigue, fever, weight loss and have no interest in eating.

A simple lab test, the sed rate, helps confirm the diagnosis. The patient’s blood is put into a calibrated tube. The distance that the red blood cells drop (sediment) from the top of the tube in one hour is the sed rate. Some of the highest sed rates ever seen in medicine are seen in polymyalgia.

In as many as 20% of patients, polymyalgia is linked to another illness, temporal arteritis, also called giant cell arteritis. Temporal arteritis is artery inflammation. Headache is one symptom, as is pain over the temporal artery - the artery at the side of the head, the temple.

Fortunately, both illnesses respond to treatment with prednisone, one of the cortisone drugs. Temporal arteritis calls for quick intervention, since inflammation of the artery serving the eye’s retina can lead to permanent blindness.

For most polymyalgia patients, a low dose of prednisone quickly relieves symptoms. Low-dose prednisone rarely creates the problems associated with higher doses of cortisone drugs. Treatment can take as long as two or more years, but that’s not the case for every patient.

A word of clarification: “Polymyalgia” indicates muscle pain. Actually, the illness comes from inflammation of bursa and joint linings.