Medications, Physical Therapy, and Lifestyle Measures
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Polymyalgia rheumatica treatment nearly always involves medications called corticosteroids (also known simply as steroids). While these drugs tend to be highly effective, some people experience intolerable side effects that require other medications — either along with a low dose of corticosteroids, or instead of corticosteroids.
Corticosteroids
Corticosteroids may cause the following side effects, Cleveland Clinic notes:
Corticosteroids for polymyalgia rheumatica are taken by mouth. The most commonly prescribed drug is prednisone (Deltasone). A typical starting dose of prednisone for polymyalgia rheumatica is 10 to 15 milligrams (mg) daily, according to Cleveland Clinic.
Methotrexate
Methotrexate is a drug that suppresses the immune system, and it’s used to treat several forms of arthritis and related conditions. For some people with polymyalgia rheumatica, methotrexate is recommended along with corticosteroids.
Sarilumab (Kevzara)
This biologic drug belongs to a category known as anti-interleukin 6 agents (or IL-6 receptor blockers). It was approved for polymyalgia rheumatica in 2023 in the United States, and it may be used when corticosteroids are not effective or cannot be tolerated over time.
Sarilumab is given as an injection every two weeks for as long as needed to prevent PMR symptoms.
Physical Therapy and Exercise
For some people, physical therapy for polymyalgia rheumatica may be beneficial and help you return to your everyday activities once you begin drug treatment. This is particularly true if your PMR previously left you unable to do certain activities, per Mayo Clinic — so you may have lasting muscle weakness from not using those muscles as you normally would.
Exercise, on the other hand, is important for everyone with polymyalgia rheumatica and can help maintain joint flexibility, muscle strength, and muscle coordination and function. The Arthritis Foundation suggests the following activities as good choices for people with PMR:
It’s also important to get enough rest, so that your joints and muscles can recover from exercise and everyday activities that may put an extra strain on them when you have PMR.
Lifestyle Measures and Home Remedies
- Fruits and vegetables
- Fish, especially fatty fish like salmon, herring, sardines, and anchovies
- Nuts and seeds
- Beans and other legumes
You should also avoid highly processed foods, including refined carbohydrates, and limit sources of unhealthy saturated fat like red meat and full-fat dairy products.
For some mild cases of polymyalgia rheumatica, taking a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil) or naproxen (Aleve) may be enough to control your symptoms, the Arthritis Foundation notes.
Don’t stop taking a prescription drug or switch to an over-the-counter NSAID just because your symptoms are gone — doing so may lead to a return of symptoms and complicate your treatment. Talk to your doctor if you’d like to explore changing your treatment because of corticosteroid side effects or any other reason.
Emerging Treatments
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