Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory syndrome typically manifested by significant stiffness and dull, aching pain of the proximal muscle groups; weight loss; malaise; and fever. It is more common among people of northern European descent, is rare among blacks and Asians, and favors the elderly (onset is rare in people under age 50). Twice as many women are affected as men. PMR can also be associated with giant cell (temporal) arteritis.

Causes

• The exact cause of polymyalgia rheumatica is not known.
• Some people with polymyalgia rheumatica have other family members with it.

No one knows what causes polymyalgia rheumatica. Genetic factors may play a part, and so the disease might be hereditary.

Symptoms

Polymyalgia rheumatica causes moderate to severe aching and stiffness in the muscles in your hips, thighs, shoulders, upper arms and neck. Initially, you may have pain on just one side of your body, but as the disease progresses, symptoms are likely to occur on both sides.

Stiffness is usually worse in the morning or after sitting or lying down for long periods. At times, the discomfort also may be severe enough to wake you at night.

The aching and stiffness of polymyalgia rheumatica often occur suddenly, but sometimes may develop gradually

Diagnostic tests

Commonly, doctors perform two blood tests to determine whether a patient has PMR: the erythrocyte sedimentation rate (ESR) and/or the C-reactive protein (CRP) test.

Both of these blood tests give a broad indication that there is some inflammation going on in the body. Many conditions cause the ESR and CRP to change, so a number of other tests may have to be performed to exclude those that can be mistaken for PMR.

Treatment

The goal of treatment is relief of discomfort and stiffness. The disease can be very bothersome if it is not treated. Corticosteroids, such as prednisone, are prescribed in low doses.

Prevention

There is no known prevention.

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