Pain can be a part of life with polymyalgia rheumatica (PMR). This inflammatory condition causes pain and stiffness, especially in the neck, shoulders, and hips. But it can make any part of your body ache.
Corticosteroids are the main treatment for PMR. These anti-inflammatory medicines quickly bring down inflammation and relieve pain and stiffness. But sometimes steroids aren’t enough to manage PMR pain. And because steroids can cause side effects, you don’t want to stay on them for more than a few months.
More than 40% of people with PMR say they’ve tried nondrug treatments like diet, exercise, and massage to manage their pain. Some of these treatments are more helpful than others.
Methotrexate
This medicine is part of the treatment for rheumatoid arthritis and other inflammatory types of arthritis. Methotrexate blocks chemicals in your body that cause inflammation. When you bring down inflammation, it relieves pain, too.
Your doctor might prescribe methotrexate with steroids or on its own. This medicine could be an option if you:
- Often have relapses
- Can't take steroids or they don't work for you
- Need to be on medicine long-term
Over-the-Counter Pain Relievers
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen don't work as well as steroids for PMR. But it may be OK to take these medicines once in a while for minor pain. Ask your doctor if NSAIDs are a safe pain relief option for you.
Physical Therapy (PT)
PT aims to relieve pain and improve movement with exercise, stretches, heat, cold, and other treatments. It might help with PMR pain and stiffness. Your doctor can refer you to a physical therapist and write a prescription for this treatment.
Exercise
This not only reduces pain, but it also keeps muscles strong, helps make your more flexible, and prevents falls. The best exercises for PMR are low-impact ones that don't stress your joints, like:
- Walking
- Riding a stationary bike
- Swimming or exercising in a pool
- Tai chi
- Pilates
Add gentle stretches a few times a day to relieve stiffness. A physical therapist can show you how to exercise safely.
Try not to overdo it. Too much exercise could make your symptoms worse. Start any exercise program slowly and build on it a little bit at a time. Balance exercise with periods of rest.
Assistive Devices
Pain makes it harder to do everyday tasks like cooking or getting dressed. Use devices like these in your daily life to relieve the strain on achy joints:
- Easy-grip knives, forks, and spoons
- Electric can opener
- Jar opener
- Button hooks and zipper pulls
- Shower and tub grab bars
- Reaching aids
Heat or Cold
A heat pack or warming cream may help to relieve muscle aches. Cold reduces inflammation. Alternate heat and cold, or use the one that works best for you.
Acupuncture
This form of traditional Chinese medicine places very thin needles into specific points around the body. In Eastern medicine, the aim is to balance the flow of energy through the body. Western doctors believe the needles stimulate nerves and muscles and release natural painkillers.
People often use acupuncture to treat pain, including arthritis and back pain. Evidence is mixed on whether it works. Some studies find that acupuncture helps with chronic pain. Others show that it has no effect at all. Also, the studies that have been done are small and have used differing techniques. We need more research to get a clear picture of how acupuncture may help with pain.
Acupuncture is safe if you go to a licensed provider. Still, it's best to check with your doctor before you try it.
Anti-Inflammatory Diet
No diet has been proven to relieve pain or improve other symptoms of PMR. But a well-balanced diet can make you feel better overall. Try to eat more anti-inflammatory foods like these:
- Colorful fruits and vegetables
- Whole grains
- Fatty fish like salmon, trout, and sardines
Corticosteroids can cause fluid buildup and high blood pressure. Limit salt, which can make these side effects worse.
Mind/Body Techniques
Being in pain can make you anxious. When you're anxious, your muscles tense up. Tense muscles could make your pain even worse.
Mind/body techniques like these can help relax you and take your mind off your pain:
Meditation. When you meditate, you focus on the present moment and steer your mind away from sources of stress. While meditation won't get rid of pain, this practice can relax you and help you manage pain better.
Mindfulness-based stress reduction (MBSR). During this 8-week program, you meditate and practice yoga to become more aware of your thoughts and relax your body. The goal is to help you respond to stress and pain in a healthier way. In one study, a program of MBSR plus cognitive behavioral therapy (CBT) improved low back pain.
Guided imagery. When you're under stress, your body releases chemicals like cortisol that increase inflammation. Guided imagery helps you release that stress. To use guided imagery, you focus on a calming scene, like the beach. Harness all five senses to calm yourself down. Hear the crash of the waves, smell the salty air, and feel the sand between your toes. Research has found that guided imagery can ease arthritis pain.
Massage
Massage helps with pain in a few ways. It relaxes tight muscles and joints, and it relieves stress and anxiety. But you may want to avoid this therapy while you're in an active flare. And if you take steroids, make sure the therapist is extra gentle. Steroids can thin your skin and make it more likely to tear.
Try different pain management approaches until you find the ones that work for you. Check with your doctor first, to make sure the method you choose won't hurt you and that you're using it the right way.
Show Sources
Photo Credit: DigitalVision/Getty Images
SOURCES:
American College of Rheumatology: "Polymyalgia Rheumatica."
Archives of Internal Medicine: "Acupuncture for Chronic Pain: Individual Patient Data Meta-Analysis."
Arthritis & Rheumatology: "2015 Recommendations for the Management of Polymyalgia Rheumatica."
Arthritis Foundation: "Corticosteroids," "Guided Imagery for Arthritis Pain," "Methotrexate: Managing Side Effects," "Polymyalgia Rheumatica," "Self-Help Arthritis Devices."
Better Health Channel: "Polymyalgia Rheumatica."
Cleveland Clinic: "How You Can Ease Your Aches and Pains with Meditation," "Polymyalgia Rheumatica."
Cleveland Clinic Journal of Medicine: "Polymyalgia Rheumatica: An Updated Review."
Harvard Medical School: "Relieving Pain with Acupuncture," "Therapeutic Massage for Pain Relief."
Institute for Integrative Healthcare: "How a Commonly Used Steroid Affects Massage."
Institute for Mindfulness-Based Approaches: "What is MBSR?"
The Journal of the American Medical Association: "Effects of Mindfulness-Based Stress Reduction vs. Cognitive Behavioral Therapy and Usual Care on Back Pain and Functional Limitations Among Adults with Chronic Low Back Pain: A Randomized Clinical Trial."
Mayo Clinic: "Acupuncture," "Polymyalgia Rheumatica."
National Health Service (U.K.): "Treatment: Polymyalgia Rheumatica."
Polymyalgia Rheumatica & Giant Cell Arteritis UK: "Exercise and Nutrition," "Maintaining Movement, Activity and Exercise with PMR: A Self-Help Guide."
Rheumatology International: "What Non-Pharmacological Treatments do People with Polymyalgia Rheumatica Try: Results from the PMR Cohort Study."
The Rheumatologist: "Exercise Can Help Patients with Rheumatic Disease Live Well," "Mind-Body Techniques for Pain Management."
