Polymyalgia rheumatica

  • Definition
    • Polymyalgia rheumatica (PMR) is an inflammatory disorder. It involves pain and stiffness in the shoulders and often the hips.

  • Causes
    • Polymyalgia rheumatica most often occurs in people over 50 years old. The cause is unknown.

      PMR may occur before or with giant cell arteritis (also called temporal arteritis). This is a condition in which blood vessels that supply blood to the head and eye become inflamed.

  • Symptoms
    • The most common symptom is pain and stiffness in both shoulders and the neck. The pain and stiffness are worse in the morning. This pain most often progresses to the hips.

      Fatigue is also present. People with this condition find it increasingly hard to get out of bed and to move around.

      Other symptoms include:

  • Exams and Tests
    • Lab tests alone cannot diagnose polymyalgia rheumatica. Most people with this condition have high markers of inflammation such as the sedimentation rate (ESR) and C-reactive protein.

      Other test results for this condition include:

      • Abnormal proteins in the blood
      • Abnormal white blood cells
      • Anemia (low blood count)

      These tests may also be used to monitor your condition.

  • Treatment
    • Without treatment polymyalgia rheumatica does not get better. However, low doses of corticosteroids (such as prednisone) can ease symptoms within a day or two.

      • The dose can then be slowly reduced to a very low level.
      • However treatment needs to continue for 1 to 2 years. In some people even longer treatment with low doses of prednisone is needed.

      Corticosteroids can cause many side effects, so you need to be watched closely if you are taking these medicines.

  • Outlook (Prognosis)
    • Polymyalgia rheumatica most often goes away with treatment after 1 to 6 years. You might be able to stop taking medicines after this point, but check with your health care provider first.

      More severe symptoms can make it harder for you to work or take care of yourself at home.

  • When to Contact a Medical Professional
    • Call your health care provider if you have weakness or stiffness in your shoulder and neck that does not go away and you have symptoms such as fever and headache.

  • Prevention
    • There is no known prevention.

  • References
    • Hellmann DB. Giant Cell Arteritis, Polymyalgia Rheumatica, and Takayasu's Arteritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 88.

      Spiera RF. Polymyalgia rheumatic and temporal arteritis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 271.