{"id":1351,"date":"2026-06-17T09:14:40","date_gmt":"2026-06-17T06:14:40","guid":{"rendered":"https:\/\/reumatologiebucuresti.ro\/?p=1351"},"modified":"2026-06-17T09:14:40","modified_gmt":"2026-06-17T06:14:40","slug":"polimialgia-reumatica-de-ce-apar-durerile-si-intepenirea-umerilor-si-soldurilor","status":"publish","type":"post","link":"https:\/\/reumatologiebucuresti.ro\/index.php\/2026\/06\/17\/polimialgia-reumatica-de-ce-apar-durerile-si-intepenirea-umerilor-si-soldurilor\/","title":{"rendered":"Polimialgia reumatic\u0103 \u2013 de ce apar durerile \u0219i \u00een\u021bepenirea umerilor \u0219i \u0219oldurilor?"},"content":{"rendered":"

Mul\u021bi pacien\u021bi cu polimialgie reumatic\u0103 ajung ini\u021bial la ortoped, neurolog, recuperare medical\u0103 sau chiar cardiologie, deoarece durerile \u0219i rigiditatea pot fi foarte intense \u0219i pot ap\u0103rea relativ brusc.<\/span><\/span><\/p>\n

De multe ori, pacientul spune:<\/span><\/span><\/p>\n

– \u201eNu mai pot ridica bra\u021bele.\u201d<\/span><\/span><\/p>\n

– \u201eM\u0103 ridic foarte greu din pat.\u201d<\/span><\/span><\/p>\n

– \u201eParc\u0103 am grip\u0103 permanent.\u201d<\/span><\/span><\/p>\n

– \u201eNu mai am putere \u00een picioare.\u201d<\/span><\/span><\/p>\n

– \u201eDiminea\u021ba sunt aproape blocat.\u201d<\/span><\/span><\/p>\n

– \u201e\u00cemi ia mult timp p\u00e2n\u0103 m\u0103 dezmor\u021besc.\u201d<\/span><\/span><\/p>\n

Polimialgia reumatic\u0103 este o boal\u0103 inflamatorie care apare aproape exclusiv dup\u0103 v\u00e2rsta de 50 de ani \u0219i afecteaz\u0103 \u00een special zona umerilor, g\u00e2tului \u0219i \u0219oldurilor.<\/span><\/span><\/p>\n

De\u0219i numele poate sugera o boal\u0103 muscular\u0103, problema principal\u0103 este inflama\u021bia structurilor din jurul articula\u021biilor \u0219i tendoanelor, nu distrugerea direct\u0103 a mu\u0219chilor.<\/span><\/span><\/p>\n

Mul\u021bi pacien\u021bi sunt surprin\u0219i de c\u00e2t de brusc pot ap\u0103rea simptomele. Uneori, o persoan\u0103 activ\u0103 ajunge \u00een c\u00e2teva s\u0103pt\u0103m\u00e2ni s\u0103 se \u00eembrace greu, s\u0103 urce cu dificultate sc\u0103rile sau s\u0103 se ridice cu mare efort din pat.<\/span><\/span><\/p>\n

Ce simptome apar \u00een polimialgia reumatic\u0103?<\/b><\/span><\/p>\n

– dureri intense la nivelul umerilor;<\/span><\/span><\/p>\n

– dureri \u00een zona \u0219oldurilor \u0219i coapselor;<\/span><\/span><\/p>\n

– senza\u021bie marcat\u0103 de \u00een\u021bepenire diminea\u021ba;<\/span><\/span><\/p>\n

– dificultate la ridicarea bra\u021belor;<\/span><\/span><\/p>\n

– dificultate la piept\u0103nat sau \u00eembr\u0103cat;<\/span><\/span><\/p>\n

– dificultate la ridicarea de pe scaun;<\/span><\/span><\/p>\n

– urcat greu al sc\u0103rilor;<\/span><\/span><\/p>\n

– senza\u021bia de \u201e\u00een\u021bepenire\u201d dup\u0103 repaus;<\/span><\/span><\/p>\n

– dureri nocturne;<\/span><\/span><\/p>\n

– oboseal\u0103 important\u0103;<\/span><\/span><\/p>\n

– stare asem\u0103n\u0103toare gripei;<\/span><\/span><\/p>\n

– lipsa energiei;<\/span><\/span><\/p>\n

– sc\u0103dere \u00een greutate;<\/span><\/span><\/p>\n

– lipsa poftei de m\u00e2ncare;<\/span><\/span><\/p>\n

– febr\u0103 sau subfebrilitate.<\/span><\/span><\/p>\n

La unele persoane simptomele predomin\u0103 la nivelul umerilor, iar la altele \u00een zona \u0219oldurilor \u0219i coapselor.<\/span><\/span><\/p>\n

De ce apare senza\u021bia de \u00een\u021bepenire diminea\u021ba?<\/b><\/span><\/p>\n

Acesta este unul dintre cele mai caracteristice simptome ale bolii.<\/span><\/span><\/p>\n

Mul\u021bi pacien\u021bi descriu senza\u021bia astfel:<\/span><\/span><\/p>\n

– \u201eDiminea\u021ba sunt blocat.\u201d<\/span><\/span><\/p>\n

– \u201eTrebuie s\u0103 m\u0103 dezmor\u021besc.\u201d<\/span><\/span><\/p>\n

– \u201ePrimele mi\u0219c\u0103ri sunt foarte dureroase.\u201d<\/span><\/span><\/p>\n

– \u201eM\u0103 mi\u0219c mult mai greu dup\u0103 ce stau.\u201d<\/span><\/span><\/p>\n

\u00cen polimialgia reumatic\u0103, inflama\u021bia este mai accentuat\u0103 dup\u0103 perioadele de repaus, motiv pentru care simptomele sunt mai severe diminea\u021ba sau dup\u0103 stat prelungit pe scaun.<\/span><\/span><\/p>\n

Rigiditatea poate dura chiar peste o or\u0103 \u0219i uneori este at\u00e2t de important\u0103 \u00eenc\u00e2t pacientul are nevoie de ajutor pentru activit\u0103\u021bi simple.<\/span><\/span><\/p>\n

De ce nu mai pot ridica bra\u021bele?<\/b><\/span><\/p>\n

Inflama\u021bia afecteaz\u0103 frecvent structurile din jurul umerilor.<\/span><\/span><\/p>\n

Pacientul poate avea dificult\u0103\u021bi la:<\/span><\/span><\/p>\n

– ridicarea bra\u021belor deasupra capului;<\/span><\/span><\/p>\n

– \u00eembr\u0103cat;<\/span><\/span><\/p>\n

– piept\u0103nat;<\/span><\/span><\/p>\n

– luat obiecte din dulap;<\/span><\/span><\/p>\n

– \u00eentors \u00een pat.<\/span><\/span><\/p>\n

Mul\u021bi pacien\u021bi cred ini\u021bial c\u0103 au:<\/span><\/span><\/p>\n

– tendinit\u0103;<\/span><\/span><\/p>\n

– periartrit\u0103;<\/span><\/span><\/p>\n

– artroz\u0103 sever\u0103 de um\u0103r;<\/span><\/span><\/p>\n

– problem\u0103 neurologic\u0103.<\/span><\/span><\/p>\n

Uneori durerea este at\u00e2t de intens\u0103 \u00eenc\u00e2t pacientul evit\u0103 complet anumite mi\u0219c\u0103ri.<\/span><\/span><\/p>\n

De ce m\u0103 ridic at\u00e2t de greu de pe scaun sau din pat?<\/b><\/span><\/p>\n

Inflama\u021bia din zona \u0219oldurilor \u0219i centurii pelvine poate produce:<\/span><\/span><\/p>\n

– dificultate la ridicarea de pe scaun;<\/span><\/span><\/p>\n

– dificultate la cobor\u00e2t sau urcat sc\u0103ri;<\/span><\/span><\/p>\n

– mers lent;<\/span><\/span><\/p>\n

– senza\u021bie de lips\u0103 de putere \u00een coapse.<\/span><\/span><\/p>\n

Unii pacien\u021bi spun:<\/span><\/span><\/p>\n

– \u201eParc\u0103 nu m\u0103 mai \u021bin picioarele.\u201d<\/span><\/span><\/p>\n

– \u201eM\u0103 ridic din mai multe \u00eencerc\u0103ri.\u201d<\/span><\/span><\/p>\n

– \u201eDup\u0103 ce stau jos, pornesc foarte greu.\u201d<\/span><\/span><\/p>\n

Pacientul poate avea impresia c\u0103 \u201enu mai are for\u021b\u0103\u201d, de\u0219i problema principal\u0103 este durerea \u0219i rigiditatea inflamatorie.<\/span><\/span><\/p>\n

Este o boal\u0103 a mu\u0219chilor?<\/b><\/span><\/p>\n

Nu \u00een sensul clasic.<\/span><\/span><\/p>\n

De\u0219i durerile sunt resim\u021bite \u00een mu\u0219chi, polimialgia reumatic\u0103 nu este de obicei o miozit\u0103 inflamatorie.<\/span><\/span><\/p>\n

Analizele musculare precum:<\/span><\/span><\/p>\n

– CK;<\/span><\/span><\/p>\n

– LDH;<\/span><\/span><\/p>\n

sunt frecvent normale.<\/span><\/span><\/p>\n

Uneori pacien\u021bii sunt trimi\u0219i la neurologie deoarece simptomele pot sugera o boal\u0103 muscular\u0103 sau neurologic\u0103.<\/span><\/span><\/p>\n

Este aceea\u0219i boal\u0103 cu poliartrita reumatoid\u0103?<\/b><\/span><\/p>\n

Nu.<\/span><\/span><\/p>\n

\u00cen poliartrita reumatoid\u0103 sunt afectate mai ales articula\u021biile mici ale m\u00e2inilor \u0219i picioarelor.<\/span><\/span><\/p>\n

\u00cen polimialgia reumatic\u0103 predomin\u0103:<\/span><\/span><\/p>\n

– durerile din zona umerilor \u0219i \u0219oldurilor;<\/span><\/span><\/p>\n

– rigiditatea important\u0103;<\/span><\/span><\/p>\n

– limitarea mi\u0219c\u0103rilor;<\/span><\/span><\/p>\n

– sindromul inflamator biologic.<\/span><\/span><\/p>\n

Totu\u0219i, uneori diferen\u021bierea poate necesita evaluare reumatologic\u0103 atent\u0103.<\/span><\/span><\/p>\n

Poate fi confundat\u0103 cu artroza?<\/b><\/span><\/p>\n

Da, foarte frecvent.<\/span><\/span><\/p>\n

Mul\u021bi pacien\u021bi sunt trata\u021bi ini\u021bial pentru:<\/span><\/span><\/p>\n

– artroz\u0103;<\/span><\/span><\/p>\n

– spondiloz\u0103;<\/span><\/span><\/p>\n

– tendinite;<\/span><\/span><\/p>\n

– hernii de disc;<\/span><\/span><\/p>\n

– fibromialgie;<\/span><\/span><\/p>\n

– afec\u021biuni neurologice;<\/span><\/span><\/p>\n

– depresie.<\/span><\/span><\/p>\n

Spre deosebire de artroz\u0103, \u00een polimialgia reumatic\u0103 apar frecvent:<\/span><\/span><\/p>\n

– debut relativ rapid;<\/span><\/span><\/p>\n

– rigiditate accentuat\u0103 diminea\u021ba;<\/span><\/span><\/p>\n

– analize inflamatorii crescute;<\/span><\/span><\/p>\n

– stare general\u0103 alterat\u0103.<\/span><\/span><\/p>\n

Analizele sunt modificate?<\/b><\/span><\/p>\n

De multe ori apar:<\/span><\/span><\/p>\n

– VSH crescut;<\/span><\/span><\/p>\n

– CRP crescut;<\/span><\/span><\/p>\n

– fibrinogen crescut.<\/span><\/span><\/p>\n

Unii pacien\u021bi se sperie c\u00e2nd v\u0103d valori foarte mari ale inflama\u021biei.<\/span><\/span><\/p>\n

Totu\u0219i, aceste modific\u0103ri sunt frecvente \u00een polimialgia reumatic\u0103.<\/span><\/span><\/p>\n

Exist\u0103 \u00eens\u0103 \u0219i situa\u021bii \u00een care analizele pot fi doar moderat crescute sau, rar, aproape normale, motiv pentru care interpretarea trebuie f\u0103cut\u0103 \u00een context clinic.<\/span><\/span><\/p>\n

Este o boal\u0103 grav\u0103?<\/b><\/span><\/p>\n

Boala poate afecta semnificativ calitatea vie\u021bii \u0219i mobilitatea, \u00eens\u0103 majoritatea pacien\u021bilor r\u0103spund bine la tratament.<\/span><\/span><\/p>\n

Problema principal\u0103 este c\u0103 pacientul poate deveni aproape imobilizat din cauza durerii \u0219i rigidit\u0103\u021bii.<\/span><\/span><\/p>\n

\u00cen plus, uneori boala poate fi asociat\u0103 cu arterita cu celule gigante.<\/span><\/span><\/p>\n

Ce leg\u0103tur\u0103 exist\u0103 cu arterita temporal\u0103?<\/b><\/span><\/p>\n

Polimialgia reumatic\u0103 poate fi asociat\u0103 cu inflama\u021bia arterelor mari, \u00een special a arterelor temporale.<\/span><\/span><\/p>\n

Trebuie evaluat urgent dac\u0103 apar:<\/span><\/span><\/p>\n

– dureri de cap noi;<\/span><\/span><\/p>\n

– sensibilitate la nivelul scalpului;<\/span><\/span><\/p>\n

– durere la mestecat;<\/span><\/span><\/p>\n

– vedere \u00eence\u021bo\u0219at\u0103;<\/span><\/span><\/p>\n

– vedere dubl\u0103;<\/span><\/span><\/p>\n

– pierderea brusc\u0103 a vederii.<\/span><\/span><\/p>\n

Aceste simptome necesit\u0103 prezentare medical\u0103 rapid\u0103 deoarece exist\u0103 risc de afectare ocular\u0103 sever\u0103 \u0219i chiar pierderea ireversibil\u0103 a vederii.<\/span><\/span><\/p>\n

Cum se trateaz\u0103 polimialgia reumatic\u0103?<\/b><\/span><\/p>\n

Tratamentul principal este reprezentat de corticosteroizi, cel mai frecvent:<\/span><\/span><\/p>\n

– Prednison;<\/span><\/span><\/p>\n

– Medrol (metilprednisolon).<\/span><\/span><\/p>\n

Un aspect foarte caracteristic \u00een polimialgia reumatic\u0103 este r\u0103spunsul rapid la tratament.<\/span><\/span><\/p>\n

Mul\u021bi pacien\u021bi spun:<\/span><\/span><\/p>\n

– \u201eParc\u0103 am \u00eenviat dup\u0103 tratament.\u201d<\/span><\/span><\/p>\n

– \u201e\u00cen c\u00e2teva zile m-am mi\u0219cat complet diferit.\u201d<\/span><\/span><\/p>\n

– \u201eDup\u0103 mult timp am reu\u0219it din nou s\u0103 m\u0103 ridic normal.\u201d<\/span><\/span><\/p>\n

Aceast\u0103 ameliorare rapid\u0103 este frecvent un indiciu important pentru diagnostic.<\/span><\/span><\/p>\n

Totu\u0219i, faptul c\u0103 simptomele se amelioreaz\u0103 repede nu \u00eenseamn\u0103 c\u0103 boala s-a vindecat complet.<\/span><\/span><\/p>\n

Tratamentul dureaz\u0103 de obicei luni sau chiar mai mult, \u00een func\u021bie de:<\/span><\/span><\/p>\n

– severitatea bolii;<\/span><\/span><\/p>\n

– valorile analizelor;<\/span><\/span><\/p>\n

– viteza de r\u0103spuns la tratament;<\/span><\/span><\/p>\n

– apari\u021bia eventualelor rec\u0103deri.<\/span><\/span><\/p>\n

Dozele se reduc treptat, sub supravegherea medicului reumatolog.<\/span><\/span><\/p>\n

O gre\u0219eal\u0103 frecvent\u0103 este oprirea rapid\u0103 a tratamentului imediat ce pacientul \u00eencepe s\u0103 se simt\u0103 bine.<\/span><\/span><\/p>\n

Ce se \u00eent\u00e2mpl\u0103 dac\u0103 tratamentul este redus prea repede?<\/b><\/span><\/p>\n

Boala poate recidiva.<\/span><\/span><\/p>\n

Pot reap\u0103rea:<\/span><\/span><\/p>\n

– durerile de umeri \u0219i \u0219olduri;<\/span><\/span><\/p>\n

– senza\u021bia de \u00een\u021bepenire diminea\u021ba;<\/span><\/span><\/p>\n

– dificultatea la mers;<\/span><\/span><\/p>\n

– dificultatea ridic\u0103rii bra\u021belor;<\/span><\/span><\/p>\n

– oboseala;<\/span><\/span><\/p>\n

– cre\u0219terea VSH-ului \u0219i CRP-ului.<\/span><\/span><\/p>\n

De aceea, reducerea tratamentului trebuie f\u0103cut\u0103 gradual \u0219i monitorizat.<\/span><\/span><\/p>\n

Cortizonul este periculos?<\/b><\/span><\/p>\n

Mul\u021bi pacien\u021bi se tem de corticosteroizi deoarece au auzit despre reac\u021biile adverse posibile.<\/span><\/span><\/p>\n

Administrarea pe termen lung poate favoriza:<\/span><\/span><\/p>\n

– cre\u0219tere \u00een greutate;<\/span><\/span><\/p>\n

– cre\u0219terea glicemiei;<\/span><\/span><\/p>\n

– hipertensiune arterial\u0103;<\/span><\/span><\/p>\n

– osteoporoz\u0103;<\/span><\/span><\/p>\n

– fragilitate cutanat\u0103;<\/span><\/span><\/p>\n

– insomnie;<\/span><\/span><\/p>\n

– reten\u021bie de lichide;<\/span><\/span><\/p>\n

– risc mai mare de infec\u021bii.<\/span><\/span><\/p>\n

Totu\u0219i, \u00een polimialgia reumatic\u0103, beneficiile tratamentului sunt adesea importante deoarece inflama\u021bia \u0219i limitarea func\u021bional\u0103 pot fi severe.<\/span><\/span><\/p>\n

Scopul tratamentului este folosirea celei mai mici doze eficiente, cu reducere progresiv\u0103 atunci c\u00e2nd boala permite.<\/span><\/span><\/p>\n

Sunt necesare \u0219i alte medicamente?<\/b><\/span><\/p>\n

\u00cen anumite situa\u021bii, medicul reumatolog poate recomanda \u0219i:<\/span><\/span><\/p>\n

– protec\u021bie gastric\u0103;<\/span><\/span><\/p>\n

– suplimente cu calciu \u0219i vitamina D;<\/span><\/span><\/p>\n

– tratament pentru preven\u021bia osteoporozei;<\/span><\/span><\/p>\n

– monitorizarea glicemiei \u0219i tensiunii arteriale.<\/span><\/span><\/p>\n

Uneori, la pacien\u021bii cu:<\/span><\/span><\/p>\n

– rec\u0103deri frecvente;<\/span><\/span><\/p>\n

– necesar mare de cortizon;<\/span><\/span><\/p>\n

– reac\u021bii adverse importante,<\/span><\/span><\/p>\n

pot fi utilizate \u0219i alte medicamente pentru controlul inflama\u021biei \u0219i reducerea necesarului de corticosteroid.<\/span><\/span><\/p>\n

Pot face mi\u0219care?<\/b><\/span><\/p>\n

Da, dup\u0103 controlul inflama\u021biei, mi\u0219carea este important\u0103 pentru:<\/span><\/span><\/p>\n

– men\u021binerea mobilit\u0103\u021bii;<\/span><\/span><\/p>\n

– reducerea rigidit\u0103\u021bii;<\/span><\/span><\/p>\n

– recuperarea for\u021bei musculare;<\/span><\/span><\/p>\n

– prevenirea decondi\u021bion\u0103rii fizice.<\/span><\/span><\/p>\n

Activitatea fizic\u0103 trebuie \u00eens\u0103 adaptat\u0103 perioadei bolii \u0219i toleran\u021bei pacientului.<\/span><\/span><\/p>\n

Poate reveni boala?<\/b><\/span><\/p>\n

Da, sunt posibile rec\u0103deri, mai ales \u00een perioada reducerii tratamentului.<\/span><\/span><\/p>\n

De aceea sunt importante:<\/span><\/span><\/p>\n

– controalele periodice;<\/span><\/span><\/p>\n

– monitorizarea analizelor;<\/span><\/span><\/p>\n

– evaluarea simptomelor.<\/span><\/span><\/p>\n

Se poate vindeca?<\/b><\/span><\/p>\n

Mul\u021bi pacien\u021bi ob\u021bin control bun al bolii \u0219i revin la activit\u0103\u021bile obi\u0219nuite.<\/span><\/span><\/p>\n

Evolu\u021bia difer\u0103 \u00eens\u0103 de la un pacient la altul, iar monitorizarea reumatologic\u0103 r\u0103m\u00e2ne important\u0103 pe termen lung.<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Mul\u021bi pacien\u021bi cu polimialgie reumatic\u0103 ajung ini\u021bial la ortoped, neurolog, recuperare medical\u0103 sau chiar cardiologie, deoarece durerile \u0219i rigiditatea pot fi foarte intense \u0219i pot ap\u0103rea relativ brusc. De multe ori, pacientul spune: – \u201eNu mai pot ridica bra\u021bele.\u201d – \u201eM\u0103 ridic foarte greu din pat.\u201d – \u201eParc\u0103 am grip\u0103 permanent.\u201d – \u201eNu mai am […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[],"class_list":["post-1351","post","type-post","status-publish","format-standard","hentry","category-boli-reumatice"],"_links":{"self":[{"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/posts\/1351","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/comments?post=1351"}],"version-history":[{"count":1,"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/posts\/1351\/revisions"}],"predecessor-version":[{"id":1352,"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/posts\/1351\/revisions\/1352"}],"wp:attachment":[{"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/media?parent=1351"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/categories?post=1351"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/reumatologiebucuresti.ro\/index.php\/wp-json\/wp\/v2\/tags?post=1351"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}