Massage therapy · Kitchener–WaterlooPolymyositis

The most common symptom is muscle weakness, which can start very gradually and cause you to trip or fall a lot (NHS, 2023). It can make it hard to raise your arms over your head, get up from a sitting position or climb stairs (MedlinePlus, 2025). Patients can also feel tired, have weight loss, morning stiffness or just a general feeling of discomfort (MedlinePlus, 2025), and some people have problems with swallowing or breathing (NHS, 2023).

The cause is unknown. It is thought to be down to a mix of genetic and environmental factors, and nothing a person has done themselves (Myositis UK, n.d.). Diagnosis usually starts with a physical examination, checking the strength of the muscles in the limbs, and then blood tests for muscle enzymes such as creatine kinase (CK), which are released into the blood when muscles are damaged (Myositis UK, n.d.). An electromyography (EMG) test may be done; this records the electrical activity in your muscles using a tiny needle placed in the muscle (NHS, 2023; Myositis UK, n.d.). The diagnosis may be confirmed by a muscle biopsy, where a small piece of muscle is taken and examined under a microscope (Myositis UK, n.d.).

If polymyositis is associated with a patchy, red skin rash, usually on the eyelids, face, neck and the backs of the hands, it may be dermatomyositis (NHS, 2023).

Most of the skeletal muscles are attached to two different bones using tendons. Tendons are tough bands of connective tissue with strong collagen fibres firmly attaching the muscles to the bones. Tendons are under a lot of stress when the muscles are pulling on them, so they are very strong.

Exercise is encouraged, even in the early stages of the condition, guided by your doctor and physiotherapist (Myositis UK, n.d.). Physiotherapy can help you stay active and improve your muscle strength (NHS, 2023), and a safe exercise programme led by a specialist physiotherapist or occupational therapist can improve quality of life and function (Oldroyd et al., 2022). Physical therapists can show you exercises to help improve and maintain flexibility and strength, and give advice on an appropriate activity level for your condition.

2. Speech and Language Therapy

If the muscles you use for swallowing or speaking become weak, you may be offered speech and language therapy (NHS, 2023; Oldroyd et al., 2022). A speech and language therapist can assess your swallowing and help you manage these changes.

3. Medicines

Medicines are a key part of treatment for polymyositis and are prescribed and monitored by your doctor or specialist team (NHS, 2023). See the list below.

Options outside my scope

• Steroids: for most people, the first treatment is a steroid medicine (usually prednisolone taken by mouth) to reduce inflammation and stop the immune system attacking the body; the dose is slowly reduced as muscle strength improves (MedlinePlus, 2025; Oldroyd et al., 2022; NHS, 2023). Taking steroids over a long time can cause side effects, so discuss this with your doctor.
• Immunosuppressant medicines: medicines that dampen down the immune system, such as azathioprine, methotrexate or mycophenolate, which may be used alongside or instead of steroids (MedlinePlus, 2025; NHS, 2023).
• Immunoglobulin therapy: a treatment using antibodies taken from blood donations, given through a drip if the condition is severe or not responding to other treatment (NHS, 2023; MedlinePlus, 2025).
• Checks for cancer: adults with this condition are watched carefully for signs of cancer, as there is a link between adult-onset myositis and cancer (MedlinePlus, 2025; Oldroyd et al., 2022).

How I can help (see the My Approach tab)

If muscle pain or tiredness lasts more than about an hour after treatment or exercise, we scale back. If your skin has become thin or fragile, for example after long-term steroids, I use lighter pressure. If you have shortness of breath and difficulty swallowing, call 911.