‘It felt like my ligaments were tearing’
It started with leg cramps at night. Then a mild stiffness in her shoulder. Being active, Megan wondered what she had done to sprain it. Maybe a rotator-cuff injury?
Every day, the pain intensified and spread. At night, she started propping pillows behind her neck and back. No help. Instead, the pain became excruciating, keeping her up most of the night.
She would self-medicate with ibuprofen. But it began to wear off faster and faster. Early on, a chiropractor suggested she eliminate carbohydrates and sugar, surmising they could be contributing to her inflammation. That didn’t work, either.
One morning, the pain was so severe she found herself spontaneously crying, then sobbing. “It felt like my ligaments were tearing,” recalled Megan, whose name we’ve changed to protect her privacy.
After numerous consultations and tests, doctors discovered the truth: Megan was one of only 700 people per 100,000 suffering from an affliction of unknown origin called Polymyalgia rheumatica. The condition is most prevalent in Caucasian women over 65.
An independent professional woman, she had become virtually incapacitated by her illness. One day, to her horror, Megan realized she couldn’t get out of bed. She couldn’t put any pressure on her arms, and her legs suddenly were too weak to support her.
“It hurt to put a plug into an electrical socket,” she recalled. “I couldn’t even pull a blouse over my head. I had to wear only clothes with buttons or a zipper. Eventually, I was going to bed fully clothed for the next day’s work.”
And those were on the good days, when she at least could manage to get to her office.
To get to the proper diagnosis, Megan’s physicians first had to exclude other potential causes of her excruciating pain and stiffness.
They tested her for a range of possible illnesses, from thyroid disease to rheumatoid arthritis to Lyme disease.
Doctors eliminated Fibromyalgia, brought on by abnormal sensory processing in the central nervous system. People with Fibromyalgia may be extremely sensitive to pain and other sensations, so the symptoms can appear similar to Polymyalgia, but without the inflammatory condition.
Eventually, Julie C. Callanan, MD, PhD, an expert in neurophysiology at Cape Cod Healthcare, began to suspect Megan might be suffering from a relatively rare diagnosis.
A blood test offered a clue. Megan’s erythrocyte sedimentation rate, or ESR, revealed abnormal inflammatory activity. Her immune system appeared very overactive.
“The biggest thing was that I spent a lot of time listening to Megan,” Dr. Callanan explained. “And because I am also a psychiatrist, I was able to evaluate both the physical and psychological possibilities.
“Given Megan’s age, the sudden onset of her condition and the involvement of the joints—I zeroed in on the likelihood it was Polymyalgia Rheumatica.”
Once diagnosed, Megan was referred to Jurgen Craig-Muller, MD, a board-certified rheumatologist at Cape Cod Healthcare. He prescribed Prednisone, which prevents the release of substances in the body that can cause inflammation.
For most patients, Prednisone begins to work within 24 to 48 hours, but not in Megan’s case. Initial doses did not alleviate the pain or stiffness. More doses followed and shortly, she eventually she began to feel improvement.
“Usually the disease runs its course after a year or so, and the dose of steroids for most of the time is on the safe side,” said Dr. Craig-Muller.
Now Megan is returning steadily to a normal life. She can use her arms and legs without significant pain. Her appetite is back.
“I definitely feel I have turned the corner,” she said.