Polymyalgia Rheumatica

What is polymyalgia rheumatica?

Polymyalgia rheumatica (PMR) is a disorder that causes severe stiffness and pain in the muscles of your neck, shoulders, and, less often, the lower back and hips.

How does it occur?

The cause of this disorder is not known. It generally affects people over age 50. Women are affected more often than men. Some researchers believe that PMR may be inherited. It is more common among people whose ancestors are from Germany, Great Britain, or other northern European countries.

What are the symptoms?

Symptoms may develop suddenly or gradually and include:

• stiffness and pain in the muscles of the neck, shoulders, upper arms, lower back, thighs, and hips that is often worse in the morning
• a slight fever (99 to 100°F, or 37 to 37.8°C)
• fatigue
• weight loss
• depression.

Between 10% and 15% of people with PMR also have a condition called temporal arteritis, or giant cell arteritis. When you have temporal arteritis, some of your arteries (usually the arteries on the sides of the face between the eye and the ear) become inflamed, narrowed, and sometimes completely blocked.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have lab tests and X-rays to check for other conditions that would cause your symptoms.

Although there is not a specific test for PMR, a blood test called ESR (erythrocyte sedimentation rate) may be done to check the diagnosis. The ESR helps diagnose conditions that cause inflammation. When you have polymyalgia rheumatica, the ESR is often 2 to 3 times higher than normal.

How is it treated?

Mild cases of PMR are sometimes treated with anti-inflammatory medicines such as aspirin or ibuprofen. These medicines are a type of medicine called nonsteroidal anti-inflammatory drugs (NSAIDs). Adults 65 years old and older should not take NSAIDs for more than 7 days without their healthcare provider's approval. These medicines can cause kidney and stomach problems.

In most cases, medicines called steroids are needed to treat PMR. These medicines can relieve symptoms in days to weeks.

Sometimes symptoms may be relieved completely with the medicine. After a period of time you may be able to gradually stop taking the medicine. Your symptoms may recur off and on over years. Or they may be constant and you may need daily medicine.

How long do the effects last?

With treatment, the condition typically lasts about 2 years. Symptoms may come back months or years later, however. Then you will need to treat the problem again with medicine.

How can I help myself?

• Follow your healthcare provider's treatment plan.
• Tell your provider if your symptoms come back or get worse.
• If you lose vision in one eye or have a severe headache or pain in the jaw when you chew, swallow, or talk (signs of arteritis), contact your provider right away.
• Discuss possible side effects of your medicine with your provider. Tell your provider about any side effects you have.