Write to us at: Inspire, 1 Cambridge Technopark, Newmarket Road, Cambridge, CB5 8PB, or email inspire@versusarthritis.org Ask the doctor Whether its a health niggle or emotional problem, DR SARAH JARVIS gets straight to the point Q Ive been having dreadful aches in my upper arms. My doctor has diagnosed me with polymyalgia and given me steroid tablets. Im worried about them because I know they can cause side effects. Is there any alternative? Dr Sarah Jarvis answers: Polymyalgia rheumatica, or PMR for short, causes inflammation of your larger muscles. The classic symptoms are pain, tenderness and stiffness of the muscles around your shoulders and upper arms. Less often, you can also get similar symptoms in your thighs or neck. PMR is uncommon in under 50s and most often affects people in their late 60s or older. Its diagnosed on the basis of your symptoms and a blood test called ESR. This test is also used to monitor your response to treatment. The treatment youve been given tablets of a steroid called prednisolone is the treatment of choice for PMR. They work by countering the effect of chemicals that cause inflammation inside your body and often relieve symptoms within a few days. Steroid tablets can cause side effects, especially if taken long term. These include anxiety and depression, weight gain and increased appetite, high blood pressure, thinning of the bones (osteoporosis), infections and indigestion. While your doctor will start you on a medium dose, theyll monitor your symptoms and blood tests regularly. As these improve, they will work to tail off your dose to the minimum needed to keep your symptoms at bay. Your doctor may prescribe medicine to counter the side effects for instance, tablets to protect your stomach and reduce the risk of osteoporosis. Theyll also keep an eye on your blood pressure and blood glucose levels. While you must never stop long-term steroid tablets suddenly, most people find they feel so much better on treatment that theyre happy to continue. Ask the expert LYNDA ATTIAS is a Helpline Advisor for Versus Arthritis Q I have osteoarthritis in my knees and have been told to lose weight. Should I follow a particular diet? Lynda answers: Losing excess weight can be very helpful for your knees, as weight can put extra strain on your joints. The pressure put on your knee is five to six times your body weight, so even a small amount of weight loss can really make a difference. Eating healthily and trying to lose weight can be helpful to your joints and overall health, and it can also help alleviate pain. A Mediterranean diet, which includes plenty of fruit and vegetables, pulses, nuts, olive oil and oily fish, can be very helpful for osteoarthritis. Including a few portions of oily fish every week such as salmon, mackerel and sardines could help, as these fish include omega-3 fatty acids. Cut down on saturated fats in processed foods such as cakes, pastry, biscuits, and full-fat dairy products. Plain popcorn, vegetable sticks and fruit are better options for snacks. If youre finding it difficult to motivate yourself, joining a group can be helpful. A referral to a nutritionist can also be useful, so do speak to your doctor. You can also call our freephone helpline on 0800 5200 520. Find out more Read more about PMR at versusarthritis.org/about-arthritis/ conditions