Treatment

Treatment usually involves medications to help ease your signs and symptoms. Relapses are common.

Medications

• Corticosteroids. Polymyalgia rheumatica is usually treated with a low dose of an oral corticosteroid, such as prednisone (Rayos). You'll likely start to feel relief from pain and stiffness within the first two or three days.

  After the first two to four weeks of treatment, your doctor might begin to gradually decrease your dosage depending on your symptoms and the results of blood tests. Because of potential side effects, the goal is to keep you on as low a dose as possible without triggering a relapse in your symptoms.

  Most people with polymyalgia rheumatica need to continue the corticosteroid treatment for a year or more. You'll need frequent follow-up visits with your doctor to monitor how the treatment is working and whether you have side effects.

  Long-term use of corticosteroids can result in serious side effects, including weight gain, loss of bone density, high blood pressure, diabetes and cataracts. Your doctor will monitor you closely for problems. He or she might adjust your dose and prescribe treatments to manage reactions to corticosteroid treatment.

• Calcium and vitamin D. Your doctor will likely prescribe daily doses of calcium and vitamin D supplements to help prevent bone loss as a result of corticosteroid treatment. The American College of Rheumatology recommends 1,000 to 1,200 milligrams of calcium supplements and 600 to 800 international units of vitamin D supplements for anyone taking corticosteroids for three months or more.
• Methotrexate. Joint guidelines from the American College of Rheumatology and the European League Against Rheumatism suggest using methotrexate (Trexall) with corticosteroids in some patients. This is an immune-suppressing medication that's taken by mouth. It might be useful early in the course of treatment or later, if you relapse or don't respond to corticosteroids.

Physical therapy

Most people who take corticosteroids for polymyalgia rheumatic return to their previous levels of activity. However, if you've had a long stretch of limited activity, you might benefit from physical therapy. Talk with your doctor about whether physical therapy is a good option for you.