Polymyositis

Polymyositis is a disease that causes muscles to become irritated and inflamed. The muscles eventually start to break down and become weak. The condition can affect muscles all over the body. This can make even simple movements difficult. Polymyositis is one disease in a group of diseases called inflammatory myopathies.

The exact cause of polymyositis is not known. It most often happens in people ages 31 to 60. It rarely occurs in people younger than 18. Experts think that polymyositis may be related to or triggered by a virus or an autoimmune reaction. An autoimmune reaction is when the body attacks its own tissues. In some cases, a medicine may lead to an allergic response that causes muscle irritation and damage. But in most cases, healthcare providers aren’t able to find the exact cause of the condition.

The condition affects muscles all over the body, and can affect the ability to run, walk, or lift objects. It can also affect the muscles that allow you to eat and breathe. The muscles that are closest to the center of the body tend to be affected the most often.

The common symptoms of polymyositis include:

• Muscle pain and stiffness.

• Muscle weakness, particularly in the belly (abdomen), shoulders, upper arms, and hips.

• Joint pain and stiffness.

• Trouble catching your breath.

• Problems with swallowing.

• Irregular heart rhythms, if the heart muscle becomes inflamed.

Polymyositis can make it hard to do everyday things. You may notice trouble walking up a flight of stairs, lifting up your arms, or getting out of your chair. As inflammation gets worse around the body, pain and weakness may affect the ankles, wrists, and lower arm area.

Weight loss and poor nutrition may become a problem if muscle weakness leads to trouble eating and swallowing.

The process starts with a health history and a physical exam. The exam will include seeing how strong your muscles are. You may need tests such as:

• Blood tests. These are done to look for signs of muscle inflammation. They also check for abnormal proteins that form in autoimmune disease.

• Electromyogram (EMG). This may be done to find abnormal electrical activity in affected muscles.

• MRI. This test uses large magnets and a computer to look for inflammation in the body.

• Muscle biopsy. Tiny pieces of tissue are taken to be checked with a microscope.

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. There's no cure for polymyositis, but the symptoms can be managed. You may need more than one kind of treatment. And your treatment may need to be changed over time. In severe cases, some treatments don't work as well. Treatments include:

• Anti-inflammatory medicines. These are steroid medicines or corticosteroids. They ease inflammation in the body. Symptoms usually get better within 4 to 6 weeks. Your healthcare provider may lower the dose of steroids after that to ease the side effects. Some people may need to take steroids ongoing to manage the disease and reduce symptoms.

• Immunosuppressive medicines. These are medicines that block or slow down your body's immune system.

• Physical therapy. This includes special exercises help to stretch and strengthen the muscles. These can help keep muscles from shrinking.

• Heat therapy and rest. These can help ease muscle symptoms.

• Braces or other special devices. These can help to support muscles and help with movement.

Talk with your healthcare providers about the risks, benefits, and possible side effects of all medicines.

If polymyositis is not treated, it can lead to severe complications. As the muscles become weaker, you may fall often and be limited in your daily activities. If the muscles in the digestive tract and chest wall are affected, you may have problems breathing (respiratory failure), malnutrition, and weight loss. Polymyositis that is treated but can't be managed well can cause severe disability. This includes an inability to swallow or breathe without help.

There is no known way to prevent polymyositis, because the exact cause is not known. In some cases where medicines may be to blame, stopping these medicines can prevent future episodes of the condition. Don't stop taking any medicine without your doctor's approval.

If your symptoms get worse or you notice new symptoms, call your healthcare provider. If you have trouble breathing or can't swallow normally, you may need emergency medical help.