Association between characteristics of pain and stiffness and the functional status of patients with incident polymyalgia rheumatica from primary care.

This paper aims to examine the relationship between different characteristics of pain and stiffness and the functional status of patients with newly diagnosed polymyalgia rheumatica (PMR). Baseline analysis of an inception cohort study was conducted. Patients aged ≥18 years, with a new diagnosis of PMR were recruited from 382 English general practices. Participants were mailed a baseline questionnaire, including separate pain and stiffness manikins and numerical rating scales (NRS), a question on their ability to raise their arms above their head and the modified Health Assessment Questionnaire (mHAQ) to examine participants' functional status. Linear regression analysis, reported as regression co-efficients (95% confidence intervals (95% CI)), was used to assess the association of pain and stiffness with function, initially unadjusted and then adjusted for age, gender, deprivation status, smoking status, BMI, anxiety and depression. Six hundred fifty two patients responded to the baseline survey (88.5%). The majority (88.2%) reported no, or mild impairment in their functional status. Adjusted linear regression analysis demonstrated that high (NRS ≥8) pain (0.20 (95% CI 0.10-0.28)) or stiffness (0.18 (0.09-0.26)) ratings, an increasing number of sites of pain (0.18 (0.06-0.29)) or stiffness (0.19 (0.08-0.31)) and shoulder pain (0.18 (0.05-0.31)), stiffness (0.10 (0.01-0.20)) and difficulty raising arms above one's head (0.19 (0.10-0.28)) were all associated with increased functional impairment. The majority of newly diagnosed PMR patients reported no or minimal functional difficulty. However, those who experience severe or widespread pain or stiffness often have significant functional limitation in performing their daily activities and may be a subset worthy of additional focus in primary care.

Evidence-based management for polymyalgia rheumatica for rheumatology practitioners, nurses and physiotherapists.

Evidence-based practice is an increasingly popular term, used in a variety of clinical settings and situations. Practitioners are encouraged to use best evidence as part of clinical decision-making when caring for individual patients. This evidence, combined with practitioner expertise and knowledge, aims to inform practice, ensuring that accurate, effective and safe treatment options are utilized.

Rehabilitation of orthopedic and rheumatologic disorders. 2. Connective tissue diseases.

This self-directed learning module highlights assessment and therapeutic options in the rehabilitation of patients with connective tissue diseases. It is part of the chapter on rehabilitation of orthopedic and rheumatologic disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. New advances covered in this article include the management of patients who have polymyalgia rheumatica, juvenile rheumatoid arthritis, ankylosing spondylitis, rheumatoid cervical spine, and rheumatoid hand.

[Psychosomatic aspects of rheumatic diseases]. / Psychosomatische Aspekte bei rheumatischen Erkrankungen.

The spectrum of rheumatic diseases includes syndromes characterized solely by musculoskeletal pain and discomfort. Indeed, muskuloskeletal pain and dysfunction are experienced by almost everyone in the course of a lifetime. The rheumatic syndromes are diverse and often of unclear etiology. For many years, psychosomatic theories have been advanced as an attempt at explanation, especially in the case of chronic polyarthritis. This article discusses the meaning of risk factors viewed as relevant to the course of back pain syndromes in particular. Therapeutic and rehabilitative-psychological interventions for comprehensive treatment of chronic rheumatic pain-patients are presented, and the necessity for a well-coordinated psychosomatic-interdisciplinary approach is emphasized.

[Rheumatic diseases in advanced age--psychological aspects]. / Rheumatische Erkrankungen im höheren Lebensalter--Psychologische Aspekte.

This paper discusses the importance of cognitive representation and individual patterns of behavior for coping with chronic disease. Chronically ill patients differ very much in their psychic situation. Biographical and situational factors and the future perspective contribute to these interindividual differences. Diagnostic and therapeutical tools are discussed from a psychological perspective.