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Polymyalgia rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory disorder. It involves pain and stiffness in the shoulder and often the hip.

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), in which blood vesseks that supply blood to the head become inflamed.

Symptoms

The most common symptom is pain and stiffness in both shoulders and the neck. This pain usually progresses to the hips. Fatigue is also present. People with this condition find it increasingly hard to move around.

Other symptoms include:

Exams and Tests

Lab tests alone cannot diagnose polymyalgia rheumatica. Most patients with this condition have a high sedimentation rate (ESR).

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

There is no cure for polymyalgia rheumatica. 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, but treatment needs to continue for about 2 - 6 years.

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

Outlook (Prognosis)

Polymyalgia rheumatica usually goes away by itself after 2 - 6 years. You can stop taking medicines after this point.

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 also 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: Saunders Elsevier;2012:chap 88.

Update Date: 2/21/2013

Updated by: Ariel D. Teitel, MD, MBA, Clinical Associate Professor of Medicine, NYU Langone Medical Center. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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