Polymyalgia Rheumatica

What is polymyalgia rheumatica (PMR)?

PMR is an inflammatory condition that causes pain, muscle aches, and stiffness that usually begin in the shoulder, neck, or hip on one side of your body. This condition primarily affects people 50 and older, often accompanied by a more serious condition called temporal arteritis.

What symptoms occur if I have polymyalgia rheumatica?

In most cases, the symptoms of PMR occur suddenly, seemingly overnight or within one day. At the longest, symptoms may gradually develop over a few weeks.

You experience moderate to severe muscle pain and stiffness in one or more of the following areas: shoulders, neck, upper arms, lower back, thighs, and hips.

Most patients find that their pain is worse in the morning or after they rest. At first, your pain may only affect one side of your body, but then it progresses to involve both sides.

You may also experience symptoms such as:

• Low-grade fever
• Loss of appetite
• Weight loss
• Fatigue
• Joint swelling and pain
• Joint degeneration
• Muscle weakness
• Vague feeling of ill health (malaise)

Your symptoms may go into remission and then suddenly flare up again, a cycle that can continue for many years. 

What is temporal arteritis?

PMR often occurs together with temporal arteritis, a condition that causes inflammation and narrowing in the small arteries in your temples. Temporal arteritis may also involve other arteries, such as the aorta.

The most common symptom of temporal arteritis is a throbbing, ongoing headache centered on one or both temples. You may also experience jaw pain, changes in your vision, and fatigue.

Without prompt treatment, temporal arteritis can lead to vision loss, an aneurysm, transient ischemic attack (mini-stroke), and stroke.

How is polymyalgia rheumatica treated?

After reviewing your medical history and completing a physical exam, your provider at Arthritis & Osteoporosis Center typically runs blood tests, especially tests to detect inflammation.

Your provider starts your treatment with a trial of corticosteroids. If you have PMR, your response to corticosteroids should be quick. Some patients improve with one dose, while others take longer and need ongoing management.

Once your symptoms improve, your provider slowly decreases the dose until they find the lowest dose that alleviates your pain. Then you continue to take that dose for a year or longer.

If your symptoms relapse, your dose of corticosteroids can be adjusted. Additionally, your provider may add another medication such as methotrexate.

If you develop pain and stiffness in your shoulders, neck, or hips, call Arthritis & Osteoporosis Center to book an appointment.