Polymyalgia Rheumatica - a condition that causes inflammation of large muscles.

As a long-standing member of the inpatient physiotherapy team at The Hospital of St John & St Elizabeth, I have worked with a variety of patients ranging in age from 23 to 103. Every patient's past medical and surgical history tells a story. Patient anecdotes regarding one particular condition, polymyalgia rheumatica (PR), piqued my curiosity about this condition. Here is an overview of PR, guidance on how patients can best manage this condition, and ideas on way to continue exercising and enjoying an active life (even at 103!).

Polymyalgia Rheumatica (PM) (cause unknown):

• Large muscles in the shoulders and hips (on both sides) are painful.
• This condition affects women over the age of 50.
• Women are 2-3 times more likely than men to be diagnosed.
• Symptoms can persist for 2+ years.
• Steroids used to manage symptoms.
• GP guidance needed to minimise osteoporotic fractures.

Physiotherapy: In addition to medication, physiotherapy can be helpful in managing the symptoms of PM and preventing osteoporosis via weight bearing activities and resistance training. Walking will often be more comfortable than running. Although weight bearing exercise is important, hydrotherapy may be an exercise option if walking is uncomfortable. If muscles are sore, ice is often more tolerable than heat for patients with PM.

Positioning and changing your position regularly is also important. Try not to sleep on your stomach or side, as this can cause tightness, “trigger points” and muscle imbalance. Instead, sleep on your back if possible and use pillows to support the backs of your knees. In addition to sleep positioning, a physiotherapist can guide you on proper seating and positioning at work. A work station assessment may be helpful.

Physiotherapy Guidance

• Vary position: move little and often
• Warm up: gently warm your muscles by walking and moving your arms
• Stretches: stretch warm muscles for 30 seconds in a pain free position

The following website/organisation offers additional information for those with PM:
http://www.arthritisresearchuk.org
The British Society for Rheumatology

Diane Daly, Senior Physiotherapist & Manual Handling Advisor, The Hospital of St John and St Elizabeth