Polymyositis: Inflammatory Myopathy

Polymyositis is a disease that causes the body’s muscles to become irritated and inflamed. It can affect the muscles all over the body. The muscles gradually begin to break down and weaken, making everyday movements difficult. This disease falls into a category known as inflammatory myopathies.

Polymyositis Unknown Causation

The causes of polymyositis are currently unknown. However, experts believe it could be associated with or triggered by a virus or an autoimmune reaction. An autoimmune response is when the body attacks itself along with the body’s tissues. It’s seen in individuals ages 31 to 60 and is rarely seen in individuals younger than 18. In some instances, medication can lead to an allergic reaction/response that causes muscle irritation and damage. But in most cases, healthcare experts are not able to find the exact cause.

Symptoms

The condition can affect the muscles all over the body. Physical activities like walking, getting up from a chair, or lifting objects can become difficult to perform. It can also affect the muscles that allow for eating and breathing. The muscles at the center of the body tend to be affected the most. Common symptoms include:

• Muscle pain.
• Muscle stiffness.
• Muscle weakness, specifically in the abdomen, shoulders, upper arms, and hips.
• Joint pain and stiffness.
• Breathing problems.
• Problems swallowing.
• Abnormal weight loss can become an issue if there are problems with swallowing.
• Irregular heart rhythms if the heart muscle/myocardium becomes inflamed.
• Individuals may notice they have trouble climbing stairs or lifting their arms.
• The inflammation can worsen, causing pain and weakness that affects the wrists, lower arms, and ankles.

Diagnosis

Diagnosis begins with the individual’s medical history, family medical history if necessary, and a physical examination. The examination includes seeing and feeling the strength of the muscles. Tests will be required that include:

Blood Tests

• Blood tests allow the doctor to see if there are signs of muscle inflammation.
• They also show if there are abnormal proteins that form in autoimmune diseases.

Electromyogram EMG

• This test can be used to find abnormal electrical activity in the affected muscles.

MRI

• Magnets and computer graphic imagery are used to help the doctor inspect for inflammation in the body.

Muscle Biopsy

• A small piece of muscle tissue is removed to be analyzed with a microscope.

Treatment

Treatment depends on how severe the condition is, individual symptoms, age, and overall health. Currently, there is no cure for polymyositis, but symptoms can be managed. Individuals are recommended to utilize more than one type of treatment because the treatment plan may also need to be changed as treatment progresses. Treatments include:

Anti-inflammatory Medication

Steroid medication can help manage the disease and reduce symptoms, and corticosteroids can help ease inflammation in the body. The symptoms improve within 4 to 6 weeks, and a healthcare provider can lower the dosage after the symptoms decrease to reduce and ease any side effects.

Immunosuppressive Medication

• These medications block or slow down the body’s immune system responses.
• Talk with a doctor about the risks, benefits, and side effects of all medications.

Chiropractic and Physical therapy

• Chiropractic treatment and physical therapy can help:
• Aligning the spine to provide optimal nerve energy and blood circulation.
• Therapeutic massage to stimulate and keep the muscles loose.
• Specific exercises to help stretch and strengthen the muscles.
• These can help keep the muscles from shrinking.

Heat therapy and Rest

• Heat therapy and allowing the body to rest thoroughly can help decrease pain symptoms.

Special Braces

• Body, hip, and leg braces can help support the muscles and help with mobility.

Complications

Polymyositis left untreated can lead to severe complications. The muscles become weaker, increasing the risk of falling and limiting daily activities.

• If the chest muscles are affected, there could be problems with breathing that can lead to respiratory failure.
• If the digestive tract is affected, malnutrition and unintentional weight loss can result.
• Polymyositis poorly managed well can cause severe disability.

Body Composition

Nutrition and Muscle Growth

Protein

• Protein is the foundation for gaining muscle.
• This essential component is for all of the body’s daily functions.
• It is essential to balance protein increase with overall diet.

Complex Carbs

• Carbs are the body’s fuel source.
• Carbs should be a daily element of nutritional intake because they are the primary component.
• Acquiring energy
• Preventing muscle weakness and degradation

Consuming Carbs

• Understanding how accurate results only happen when both sides work together.
• Healthy consumption of protein and carbohydrates can help muscle growth and sustain optimal health for all body types.

References

Corrado, Bruno et al. “Supervised Physical Therapy and Polymyositis/Dermatomyositis-A Systematic Review of the Literature.” Neurology international vol. 12,3 77-88. 24 Nov. 2020, doi:10.3390/neurolint12030015

Findlay, Andrew R et al. “An overview of polymyositis and dermatomyositis.” Muscle & nerve vol. 51,5 (2015): 638-56. doi:10.1002/mus.24566

Sasaki, Hirokazu, and Hitoshi Kohsaka. “Current diagnosis and treatment of polymyositis and dermatomyositis.” Modern rheumatology vol. 28,6 (2018): 913-921. doi:10.1080/14397595.2018.1467257

Van Thillo, Anna et al. “Physical therapy in adult inflammatory myopathy patients: a systematic review.” Clinical rheumatology vol. 38,8 (2019): 2039-2051. doi:10.1007/s10067-019-04571-9