Polymyositis

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Polymyositis

Managing Polymyositis Effectively

Polymyositis is a long-term, or chronic, inflammatory muscle disease that causes progressive weakness in the skeletal muscles. These are the muscles involved in movement, especially those closest to the trunk like the shoulders, hips, and thighs. It can also affect the neck and upper arms, making daily activities more difficult. Polymyositis occurs when the immune system mistakenly attacks healthy muscle tissue, making it an autoimmune condition. It differs from conditions like muscular dystrophy, which are inherited. In polymyositis, inflammation causes muscle fibers to break down over time. This leads to weakness rather than joint pain and can eventually impact swallowing or breathing if left untreated.

The inflammation in polymyositis may also involve the lungs or heart. Early diagnosis and proper treatment with medication and physical therapy can improve muscle strength and prevent serious complications. Without care, the condition can cause long-term muscle damage and disability.

Polymyositis Symptoms

Polymyositis Symptoms

Polymyositis is a chronic condition that causes inflammation of the muscles, leading to progressive weakness, fatigue, and difficulty performing everyday activities if not properly managed.

  • Muscle weakness often begins in the hips or shoulders and may worsen over time.
  • Weakness makes daily tasks like climbing stairs or lifting arms difficult.
  • Fatigue, mild shortness of breath, and muscle pain may occur early.
  • As symptoms progress, the neck, thighs, and back muscles may weaken.
  • Muscle weakness is usually symmetrical, affecting both sides of the body.
  • Lungs, heart, and esophagus may also be affected in severe or late cases.

Diagnosis

Diagnosing polymyositis early is important, but its initial symptoms can mimic other muscle disorders, making it difficult to identify.

  • Doctors assess muscle strength and look for signs of tenderness or swelling in key areas.
  • Blood tests check muscle enzyme levels and detect autoantibodies linked to the disease.
  • MRI scans provide detailed images to locate muscle inflammation and tissue changes.
  • Electromyography measures electrical activity in muscles to confirm abnormal function.
  • A muscle biopsy may reveal inflammation, damaged fibers, or enzyme abnormalities.

Treatment Options

Although polymyositis cannot be cured, early intervention with medications and physical therapy can help manage symptoms and prevent long-term muscle damage.

  • Corticosteroids help reduce muscle inflammation but may cause weight gain or bone loss over time.
  • Steroid-sparing drugs like methotrexate or azathioprine reduce side effects and support long-term control.
  • Immunosuppressants such as mycophenolate or tacrolimus may be added for more severe cases.
  • Biologic agents like rituximab are used if symptoms don’t improve with first-line therapies.
  • Early treatment improves outcomes, and plans are tailored based on your symptoms and response.

Therapy & Surgery

Physical therapy and, in rare cases, surgery can help restore strength, enhance mobility, and address complications when medications alone are insufficient.

  • Therapists guide gentle exercises to improve strength, flexibility, and daily mobility safely.
  • Speech therapy helps manage swallowing issues when throat muscles become weakened.
  • IVIg infusions may block harmful antibodies and are repeated for lasting immune control.
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