What is Myositis?

Myositis is a rare group of diseases that cause inflammation in the muscles and can include both muscle tissue and connective tissue in certain forms. This can lead to muscle weakness, pain, and sometimes fatigue. The word myositis means “muscle inflammation” (myo = muscle, itis = inflammation). It can affect anyone, but some types are more common in certain age groups.

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Types of Myositis

There are several kinds of myositis, each with its own features:

  • Polymyositis (PM): Causes muscle weakness, mainly in the muscles closest to the center of the body (like the hips and shoulders)
  • Dermatomyositis (DM): Similar to polymyositis but also includes a skin rash. It can also cause a heliotrope rash (a purple discoloration around the eyes)
  • Inclusion Body Myositis (IBM): The most common type in older adults. It causes slow, progressive, and asymmetrical muscle weakness, particularly in the wrist and finger flexors, and quads
  • Immune-Mediated Necrotizing Myopathy (IMNM): A more severe type with fast muscle cell damage
  • Juvenile Myositis: Affects children, especially a form called juvenile dermatomyositis, which often causes muscle weakness and skin manifestations

Common Myositis Symptoms

  • Weakness in the shoulders, hips, or neck
  • Trouble climbing stairs, standing up, or lifting arms
  • Muscle pain or tenderness
  • Feeling tired or unwell
  • Difficulty swallowing (in more advanced cases)
  • In dermatomyositis, a rash on the face, knuckles, elbows, knees, or chest
  • Muscle atrophy (wasting) in advanced stages

What Causes Myositis?

The exact cause isn’t always known, but it’s often linked to the immune system attacking healthy muscle tissue. Triggers may include:

  • Genetics
  • Viral infections
  • Certain medications
  • Environmental exposures
  • Other autoimmune diseases

How Is Myositis Treated?

Myositis treatment typically involves a multi-pronged approach aimed at reducing inflammation, preserving muscle function, and managing symptoms. The approach is tailored to each patient’s specific type and severity of myositis.

Steroids

  • First-line treatment for reducing inflammation
  • Prednisone is commonly prescribed
  • Often given in high doses initially, then gradually reduced
  • Can cause significant long-term effects like osteoporosis and weight gain

Immunosuppressants

  • Methotrexate, azathioprine, and mycophenolate mofetil
  • Help reduce steroid dosage and related side effects
  • May take several months to show maximum benefit
  • Can be used to decrease the need for steroids

Biologic Therapies

  • Rituximab, which targets B-cells involved in the immune response
  • Intravenous immunoglobulin (IVIG) for severe or resistant cases
  • Particularly effective in treating resistant forms of myositis
  • Targeted therapies showing promise in clinical trials

Physical Therapy

Physical therapy is a cornerstone of myositis treatment, providing:

  • Build or maintain strength
  • Prevent muscle shrinking
  • Improve movement and flexibility
  • Manage daily tasks with less strain
  • Should be tailored to each patient; overexertion can exacerbate symptoms
A provider talking to a young girl who is receiving infusion therapy

Monitoring Myositis and Ongoing Care

Living with myositis presents challenges, but with proper medical care, physical therapy, and lifestyle adaptations, many patients lead fulfilling lives. Early diagnosis and treatment offer the best opportunity for managing symptoms and preserving muscle function. Treating myositis is not one-size-fits-all. Regular check-ins and tests are required to see how you’re doing and adjust treatments as needed. This may include:

  • Strength testing
  • Blood tests to check muscle enzymes
  • Monitoring side effects
  • Reviewing treatment plans as needed
  • Muscle biopsies
  • Electromyography (EMG)
  • MRIs
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Comprehensive Myositis Management

Managing myositis involves treating flare-ups and maintaining strength between them. A full care plan may include:

  • Preventing future flares
  • Adjusting daily routines to save energy
  • Learning to manage treatments at home
  • Dosing adjustments may be needed over time
  • Regular follow-ups with your care team
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Ways to Receive Myositis Treatment

Some treatments require infusions or injections. Options include:

  • At-home care: Nurses can come to your home to give convenient treatment and lower infection risk.
  • Infusion centers: Comfortable clinics staffed with trained nurses for more complex care needs.
  • Self-treatment: Some people can learn to give themselves medicine under the skin, giving them more control over their schedule.

About Myositis Care at Soleo Health

Soleo Health offers personalized care for people with myositis and other autoimmune conditions. We work closely with your providers to create a plan that fits your needs.

Contact us today if you have any questions

References

Lundberg IE, et al. (2023). “2023 European Alliance of Associations for Rheumatology/American College of Rheumatology Classification Criteria for Myositis.” Annals of the Rheumatic Diseases, 82(2), 258-266.
The Myositis Association. (2024). “Types of Myositis.” Retrieved from https://www.myositis.org
Mammen AL. (2022). “Autoimmune Myopathies.” Continuum: Lifelong Learning in Neurology, 28(6), 1731-1751.
National Organization for Rare Disorders. (2023). “Myositis.” Retrieved from https://rarediseases.org
This content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment.