Q: I’ve been diagnosed with polymyalgia. What is the distinction between polymyalgia and fibromyalgia? What is the treatment for polymyalgia?
A: I can certainly understand the confusion between fibromyalgia and polymyalgia; the names and, to an extent, the symptoms of both conditions are similar.
The word myalgia means pain within the muscles. Both fibromyalgia and polymyalgia are characterized by muscle pain, but many other aspects of the two conditions differ.
Polymyalgia, or polymyalgia rheumatica, is an inflammatory disease of muscle. The cause is uncertain but it is believed to be an autoimmune disease in which the body’s own immune system attacks the connective tissues. The primary symptoms are severe stiffness and pain in the muscles of the neck, shoulder and hip areas. People with this condition also may have flulike symptoms, including fever, weakness and weight loss, and approximately 15 percent develop a potentially dangerous condition called giant cell arteritis – an inflammation of the arteries that supply the head.
Fibromyalgia is not an inflammatory condition. It is caused by abnormal sensory processing in the central nervous system. People with fibromyalgia may be extremely sensitive to pain and other unpleasant sensations. To be diagnosed with fibromyalgia, one must experience pain on both sides of the body and in both the upper and lower half of the body. They are also typically tender points throughout their body. Other common symptoms of fibromyalgia include fatigue, difficulty sleeping and concentrating, irritable bowel syndrome and headaches.
Both fibromyalgia and polymyalgia are more common in women than men. Fibromyalgia can occur at any age, but polymyalgia rarely occurs before age 50. The average age of onset is 70. And whereas fibromyalgia is chronic, often lasting a lifetime, polymyalgia usually resolves itself within two years.
Treatment differs, too. Fibromyalgia is treated with exercise, relaxation techniques, analgesic medications and antidepressants to relieve pain and promote sleep. Treatment for polymyalgia is targeted at relieving inflammation. For some people, daily doses of NSAIDs, such as ibuprofen (Advil, Motrin), are sufficient, but more often corticosteroids, such as prednisone, are required to control inflammation.
Although your polymyalgia will eventually go away completely, it’s important that you be mindful – both now and after your disease resolves – of symptoms such as headaches and blurred vision, which could mean giant cell arteritis. If you develop arteritis, high doses of corticosteroids may be necessary to control the condition and prevent vision loss.
Daniel Clauw, MD, Rheumatologist