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Wednesday, November 18, 2015

Most Common Diseases of Ages of 50 Plus - Musculoskeletal disorders (MSDs): Polymalgia Arthritis Treatment in Conventional Medicine Perspective

Kyle J. Norton(Scholar)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) is medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1)

                  Polymalgia Arthritis

Polymalgia Arthritis is defined as a condition a common inflammatory rheumatic disease which cause pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdleas a result of the presence of a synovitis in proximal joints and periarticular structures, causing musculoskeletal symptoms in PMR.

In conventional medicine, there is no known way to prevent Polymalgia Arthritis, although progression of the disease usually can be stopped or slowed by early, aggressive treatment. Since Polymalgia Arthritis is caused by inflammation pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdleas a result of the presence of a synovitis in proximal joints and periarticular structures. Diet with high in anti inflammatory and immunity enhancing foods, antioxidants and phytochemicals may provide protection and reduced risk of the disease.

                                   The Treatments

F.1. In conventional medicine perspective
1. Non Medication
The aim of non medical treatment is to control painful myalgia, improve muscle stiffness, and relieve the symptoms of constitutional features of the disease.
a. Fasting as part of a naturopathic treatment
Fasting may be formed part of polymyalgia rheumatica (PMR) treat. According to the report of a 67-year-old woman with proven diagnosis of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) was admitted to stationary treatment twice to receive a complex therapy with methods of natural medicine comprising fasting as its main treatment element(56)
b. Diet therapy
Leucine-rich milk and whey proteins may be a potential treatment of age related loss of muscle mass and strength, according to the study of Dr, Björkman MP, and the rerearch team at Helsinki University Central Hospital(57). Other suggested that exercise and amino acid supplementation (AAS) together may be effective in enhancing not only muscle strength, but also combined variables of muscle mass and walking speed and of muscle mass and strength in sarcopenic women(58).
c. Etc. 

2. Medical treatment
2.1. Tocilizumab (TCZ)
Tocilizumab (TCZ) is the first humanized interleukin-6 receptor-inhibiting monoclonal antibody developed to treat rheumatoid arthritis.
a. In the study to assess the outcomes of 10 patients with relapsing/refractory GCA, TAK, or PMR treated with tocilizumab (TCZ), found that TCZ led to clinical and serological improvement in patients with refractory/relapsing GCA, TAK, or PMR. The demonstration of persistent large-vessel vasculitis at autopsy of one patient who had shown substantial response requires close scrutiny in larger studies(59).
Other researchers in the study of ffficacy and safety of tocilizumab (TCZ) in patients with systemic juvenile idiopathic arthritis (SJIA): tender 52-week data indicated that TENDER 1-year results demonstrate that TCZ is highly effective and generally well tolerated in pts with sJIA(60).
b. Side Effects are not limit to
b.1. Dizziness
b.2. Headache
b.3. Allergic effects, such as rash; hives; itching; difficulty breathing, etc.
b.4. Skin changes
b.5. Tiredness or weakness
b.6. Etc. 

2.2. Corticosteroids [CS] and nonsteroidal antiinflammatory drugs [NSAIDs])
2.2.1.. Corticosteroids, a drug, a common presentation in primary care, and non-selective non-steroidal anti-inflammatory drugs (sometimes also referred to as traditional NSAIDs or tNSAIDs) and selective cyclo-oxygenase 2 inhibitors (COX-2 inhibitors)(PMR) also be the first choice of treating of Polymalagia Arthritis, but the use of CS and NSAIDs in the treatment of PMR is associated with important long-term morbidity, according to Gabriel SE, Sunku J, Salvarani C, O’Fallon WM, Hunder GG., in the study of Adverse outcomes of antiinflammatory therapy among patients with polymyalgia rheumatica(61).
2.2.2. Side effects
a. Corticosteroids [CS]
a.1. Corticosteroid withdrawal syndrome
b.2. Hyperglycemia
b.3. Insulin resistance
b.4. Diabetes mellitus
b.5. Osteoporosis
b.6. Depression
b.7. Colitis
b.8. Etc.

b. Nonsteroidal antiinflammatory drugs [NSAIDs]
NSAIDs may cause large intestinal ulcers, bleeding, and perforationoccasionally. It may cause relapse of classic inflammatory bowel diseaseand contribute to serious complications of diverticular disease (fistula and perforation). NSAIDs may occasionally cause small intestinal perforation, ulcers, and strictures requiring surgery. NSAIDs, however, frequently cause small intestinal inflammation, and the associated complications of blood loss and protein loss may lead to difficult management problems. The pathogenesis of NSAID enteropathy is a multistage process involving specific biochemical and subcellular organelle damage followed by a relatively nonspecific tissue reaction, according to Dr. Bjarnason I and the research team at King’s College School of Medicine and Dentistry(61).

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