Myositis treatment

Myositis is a chronic, progressive inflammation of the muscles. Some types are associated with skin rashes. Medications and exercises can help, but finding the right treatment may take trial and error. This rare disease can be difficult to diagnose, and the cause is sometimes unknown. Symptoms can appear rapidly or gradually over time. Primary symptoms may include muscle pain and soreness, fatigue, trouble swallowing, and difficulty breathing. In the United States, there are an estimated 1,600 to 3,200 new cases per year and 50,000 to 75,000 people living with myositis. Myositis can affect both children and adults. With the exception of one type of myositis, women are more likely to be affected by this disease than men. The five types of myositis are: • dermatomyositis • inclusion-body myositis • juvenile myositis • polymyositis • toxic myositis Dermatomyositis Dermatomyositis (DM) is the easiest form of myositis to diagnose due to the purple-red rashes in the shape of the Other symptoms of DM include: • scaly, dry, or rough skin • Gottron’s papules or Gottron’s sign (bumps found over the knuckles, elbows, and knees, often with a raised, scaly breakout) • trouble rising from a seated position • fatigue • weakness in the neck, hip, back, and shoulder muscles • difficulty swallowing • hoarseness in the voice • hardened lumps of calcium under the skin • muscle pain • joint inflammation • nail-bed abnormalities • weight loss • irregular heartbeat • gastrointestinal ulcers Incl...

While there is not yet a cure for myositis, for most patients, treatments can effectively control and improve symptoms. Ongoing research continues to add new drug options for treating myositis diseases, which gives patients and physicians options in deciding what medication is best based on the balance of risks and benefits for that individual. While most of these medications are not approved for myositis by the FDA, they are all approved for other uses and are used “off label” in myositis. Nevertheless, their use in myositis is based on research, including small clinical trials, expert experience, and individual reports in the literature of effectiveness in myositis. These are the most commonly used medications used for myositis:

People with inflammatory muscle diseases are seen in the Inflammatory Myositis Clinic at Mayo Clinic in Rochester, Minnesota, in collaboration with colleagues at the Arizona and Florida campuses. The major muscle diseases that are diagnosed and treated include adult and juvenile dermatomyositis, polymyositis, necrotizing autoimmune myopathy (immune-mediated necrotizing myopathy) and inclusion body myositis. These diseases cause muscle inflammation and damage, or both, that may be treatable. As these disorders may involve multiple organ systems, such as the skin and lungs, Mayo Clinic often involves other specialists during an evaluation. Depending on your specific needs, your evaluation may include neurologists, pulmonologists, dermatologists, physical medicine rehabilitation specialists, occupational therapists and physical therapists. To help people further, experts in the Inflammatory Myositis Clinic vigorously pursue clinical research into the causes and treatment of inflammatory myositis in collaboration with other researchers at Mayo Clinic, nationally and internationally. The clinic is a center for major treatment trials involving people with myositis, which gives patients access to the most cutting-edge treatments, depending on their conditions.

The inflammatory muscle disorders are a group of rare diseases marked primarily by muscle inflammation and weakness. In general, muscle inflammation is referred to as “myositis,” regardless of the cause – however, myositis is frequently used as shorthand to refer to common causes of inflammatory muscle disorders or idiopathic inflammatory myopathies (IIM). Types of myositis Different forms of myositis include: • Polymyositis • Dermatomyositis • Inclusion Body Myositis • Autoimmune Necrotizing Myopathy Causes of myositis The white blood cells of the immune system generally protect us from things in the environment, like bacteria and viruses. In myositis, the immune system mistakenly injures muscle tissue, causing muscle weakness and other related conditions. It is not clear why these conditions develop, or what sets it off for most people, though there are clues in some cases. While there is no cure for myositis, there are a variety of treatments that can help patients manage their symptoms successfully. Symptoms of myositis The most common symptom of myositis is muscle weakness. The weakness often develops slowly, and can be subtle at first. The symptoms of weakness depend on the group of muscles affected – most often, myositis affects the muscles closest to the trunk, at the shoulders and hips. The weakness in myositis is generally not associated with pain, but some muscle pain can be seen in about a third of patients. It can be hard to distinguish fatigue from weakness, ...

Overview What is myositis? Myositis is a disease that makes your immune system attack your muscles. It causes chronic Myositis is a type of myopathy. • Arms and shoulders. • Legs and hips. • Abdomen and spine (your trunk). Other people with myositis experience muscle weakness on or near their: • • • Experts aren’t certain what causes myositis, and there’s no cure for it. Your healthcare provider will treat the symptoms you’re experiencing. They’ll also recommend exercises like stretching and physical movements that can help strengthen your affected muscles between episodes of myositis symptoms. Visit a healthcare provider if you feel weak, have trouble moving or notice new pain or rashes on your skin. Go to the emergency room if you have trouble breathing or swallowing. What are the types of myositis? A healthcare provider will diagnose a type of myositis based on your symptoms and the location of your affected muscles. There are a few different forms of myositis, including: • • • Polymyositis Polymyositis affects multiple muscles at the same time. It usually causes symptoms in muscles on or near the center of your body. Polymyositis develops gradually over time. It typically affects adults. Women and people assigned female at birth are twice as likely to develop polymyositis than men and people assigned male at birth. If you have polymyositis, you might have trouble performing movements you usually can, including: • Standing up after sitting. • Climbing stairs. • Lifting ...

Causes of Myositis Myositis is caused by any condition that leads to Inflammatory conditions. Conditions causing inflammation throughout the body may affect the muscles, causing myositis. Many of these causes are autoimmune conditions, in which the body attacks its own tissues. Inflammatory conditions causing potentially severe myositis include: • Dermatomyositis • Polymyositis • Inclusion body myositis Other inflammatory conditions tend to cause milder forms of myositis, including: • Lupus • • Rheumatoid arthritis Inflammatory conditions are often the most serious myositis causes, requiring long-term treatment. Infection. Drugs. Many different • Alpha- • Alcohol • • • • Myopathy may occur right after starting a medication or may occur after taking a drug for months or years. Sometimes it is caused by an interaction between two different medications. Severe myositis caused by medications is rare. Injury. Vigorous Rhabdomyolysis . Rhabdomyolysis occurs when muscles break down quickly. Symptoms of Myositis The main symptom of myositis is muscle weakness. The weakness may be noticeable or may only be found with testing. Muscle pain (myalgias) may or may not be present. The weakness from myositis can lead to falls and make it difficult to get up from a chair or after a fall. Other symptoms that may be present with inflammatory conditions include: • • • Thickening of the • Difficulty swallowing • Difficulty breathing People with myositis caused by a virus usually have symptoms ...

As of now, there is no cure for myositis. However, management of the disease is critical in order to reduce inflammation caused by myositis and to prevent muscle weakness from progressing. Further, your doctor will recommend lifestyle changes so you can restore your strength. There are two approaches to treatment for myositis: • medical treatment • lifestyle management changes Medical Treatment Your doctor will probably recommend a course of medical therapy using the following 2 classes of drugs: • Corticosteroids (i.e., prednisone) and other drugs that suppress the immune system (immunosuppresants) may slow down the attack on healthy tissue and improve skin rash. Your doctor will probably repeat blood tests throughout your treatment for myositis to monitor improvement. • Anti-inflammatories You may also want to use nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen for pain relief. Lifestyle Management Changes Exercise. After drug treatment takes effect, a program of regular stretching exercises prescribed by your doctor can help maintain range of motion in weakened arms and legs. Physical therapy may also help prevent permanent muscle shortening. You may also want to add whirlpool baths, heat and gentle massage. Rest. Getting enough rest is an important component of managing myositis. Take frequent breaks during the day and limit your activity. Nutrition. What you eat can affect your overall health. At the Myositis Center, a trained nutritionist i...

Myositis diseases vary widely from one patient to another, so no one treatment will work for everyone. There are a number of medications available that may be used individually or in combination to treat most forms of the disease. Sometimes, some trial and error may be needed to settle on the best treatment plan, and the risks of serious side effects must often be balanced against the therapeutic benefit of these powerful drugs. Regrettably, for some forms of myositis, particularly inclusion body myositis, there are no treatments available yet. Because myositis and its treatments are so variable, it is also extremely important that you communicate well with your physician about your treatment, its effectiveness, and any side effects you may experience. Keep in mind that medications are only one step in treating myositis diseases. There are many other therapies that patients find helpful and are recommended to assist you live life to the fullest, despite the challenges of chronic disease. While polymyositis, dermatomyositis, necrotizing myopathy, and overlap disorders all, to varying degrees, are responsive to immune suppression and other therapies, sporadic inclusion body myositis still has no effective treatment. Nevertheless, research continues to better understand sIBM, and a number of compounds are currently being studied as

Diagnosis If your doctor suspects that you have dermatomyositis, he or she might suggest some of the following tests: • Blood analysis. A blood test will let your doctor know if you have elevated levels of muscle enzymes that can indicate muscle damage. A blood test can also detect autoantibodies associated with different symptoms of dermatomyositis, which can help in determining the best medication and treatment. • Chest X-ray. This simple test can check for signs of the type of lung damage that sometimes occurs with dermatomyositis. • Electromyography. A doctor with specialized training inserts a thin needle electrode through the skin into the muscle to be tested. Electrical activity is measured as you relax or tighten the muscle, and changes in the pattern of electrical activity can confirm a muscle disease. The doctor can determine which muscles are affected. • MRI. A scanner creates cross-sectional images of your muscles from data generated by a powerful magnetic field and radio waves. Unlike a muscle biopsy, an MRI can assess inflammation over a large area of muscle. • Skin or muscle biopsy. A small piece of skin or muscle is removed for laboratory analysis. A skin sample can help confirm the diagnosis of dermatomyositis. A muscle biopsy might reveal inflammation in your muscles or other problems, such as damage or infection. If the skin biopsy confirms the diagnosis, a muscle biopsy might not be necessary. Treatment There's no cure for dermatomyositis, but treatment...

Search this website Hide Search • About Myositis • Dermatomyositis • Inclusion Body Myositis • Juvenile Myositis • Polymyositis • Toxic Myopathies • Myositis Disease Education Videos • Our Center • Our Doctors • Our Team • Directions • Physician Referral Information • Preparing for an Appointment • In The News • Our Difference • Diagnosis of Myositis • Nutrition for Myositis Patients • Treatment of Myositis • Myositis Research • Current Research Studies • Recent Publications • Make a Gift • Peter Frampton Myositis Research Fund A general term meaning inflammation of the muscles, myositis includes the following diseases: • • • • The above diseases are also referred to as inflammatory myopathies. They cause inflammation within muscle and muscle damage. Polymyositis, dermatomyositis, and juvenile myositis are all autoimmune diseases, meaning the body’s immune system is attacking the muscle. While the immune system may also cause muscle damage in inclusion body myositis, this may not be cause of this disease. Although myositis is often treatable, these diseases are poorly understood and do not always completely respond to current medications. Muscle inflammation and damage may also be caused by certain medications. These are called toxic myopathies. Perhaps the most common toxic myopathy is caused by statin medications which are frequently prescribed to lower cholesterol levels. In most cases, the muscle can recover once the problem medication is identified and stopped. Sympto...