Is Massage good for Polymyalgia Rheumatica?

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Massage therapy can potentially provide several benefits for individuals with polymyalgia rheumatica (PMR). PMR is a chronic inflammatory condition characterized by severe muscle pain and stiffness, primarily affecting the shoulders, neck, and hips.

Massage can help alleviate pain and stiffness associated with PMR by promoting circulation and reducing muscle tension. The gentle pressure and rhythmic movements of massage can stimulate blood flow, delivering oxygen and nutrients to the affected muscles. This increased circulation can help reduce inflammation and promote healing.

Massage therapy is not typically a primary treatment for Polymyalgia Rheumatica, which is an inflammatory disorder characterized by muscle pain and stiffness, especially in the shoulders and hips. The mainstay of treatment for PMR is usually corticosteroids, which can significantly reduce symptoms. However, some patients with PMR may find that massage helps to alleviate muscle stiffness and improve circulation, which could potentially provide some symptomatic relief.

Moreover, massage therapy can also help to relax the muscles and improve flexibility. The manual manipulation of the muscles during a massage can help release tension and tightness, improving range of motion and reducing stiffness. This can be particularly beneficial for individuals with PMR, as it can help them regain mobility and perform daily activities with greater ease.

In addition to its physical benefits, massage therapy can also provide psychological relief for individuals with PMR. Chronic pain conditions like PMR can take a toll on one’s mental well-being, causing stress, anxiety, and depression. Massage can help reduce these emotional burdens by promoting relaxation, reducing stress hormones, and increasing the release of endorphins, which are natural painkillers and mood elevators.

It’s important to note that while massage may offer temporary relief from muscle pain and stiffness, it should not replace conventional medical treatment for PMR.

Patients should consult with their healthcare provider before starting any new treatment, including massage, to ensure it is safe and appropriate for their specific condition.

Treatment Options for Polymyalgia Rheumatica

The treatment options for PMR are aimed at reducing inflammation and managing symptoms to improve the quality of life. The main treatment options include:

  • Glucocorticoids
  • Oral Glucocorticoids: These are the cornerstone of PMR treatment. Many patients respond to long-term, low-dosage oral glucocorticoids, which can significantly reduce symptoms.

  • Steroid-Sparing Agents
  • Methotrexate: This is an alternative treatment option that may be used as a steroid-sparing therapy to reduce the dose and potential side effects of glucocorticoids.
  • Tocilizumab: An interleukin-6 (IL-6) receptor antagonist, tocilizumab has shown promise as a treatment option in some studies and may be considered for patients with frequent relapses or those who cannot taper glucocorticoids without a return of symptoms.

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
  • NSAIDs: These may be used to reduce pain, although they are not the primary treatment for the inflammatory aspects of PMR.

  • Additional Considerations
  • Monitoring for Adverse Effects: Long-term use of glucocorticoids can lead to adverse effects such as osteoporosis, hypercholesterolemia, hypertension, diabetes mellitus, cataracts, and infections. Therefore, monitoring and managing these risks is an important part of the treatment plan.
  • Bone Mineral Density: Due to the risk of osteoporosis with long-term glucocorticoid use, bone mineral density may be monitored, and treatment for osteoporosis may be initiated.

  • Investigational Therapies
  • IL-6 Receptor Inhibition: Research into genetically proxied IL-6 receptor inhibition suggests that IL-6 signaling plays a key role in PMR pathophysiology, and IL-6 receptor inhibitors may be a potential treatment option.
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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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