Understanding Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory condition that can cause aching and stiffness. It often affects the neck, shoulders, and hips. The aching and stiffness are often worse in the morning.

PMR can come on suddenly. For some it seems to occur overnight. For others it can take days or weeks to develop. PMR affects older adults and often occurs after age 50. It becomes more common with age. PMR occurs most often between ages 70 and 80. It's more common in women than in men, and it seems to run in some families.

What causes polymyalgia rheumatica?

The exact cause is unknown. Researchers are working to learn what causes PMR. The condition can happen quickly and tends to occur at certain times of year. Some experts think that an infection may be the cause, or it may be linked to immune system problems. Genes may also be part of the cause. PMR can run in some families.

Symptoms of polymyalgia rheumatica

The main symptoms of PMR are aching and stiffness of the shoulders, neck, and hips. The aching can extend to the upper arms and thighs. PMR often affects both sides of the body equally. Symptoms are often worse in the morning or after long periods of no activity. Movement can make the pain worse.

The symptoms of PMR often affect the shoulders the most. You may have trouble raising your arms above the level of your shoulders. This can make it hard to get dressed. You may have trouble rolling over in bed, getting out of bed, and getting up from sitting. You may also have trouble sleeping because of your symptoms.

Other symptoms can occur. These include:

• Swelling of the hands, wrists, feet, and ankles

• Numbness, tingling, or pain in the hand, wrist, or forearm

• Feeling of weakness

• General feeling of being unwell

• Feeling tired

• Loss of appetite

• Weight loss

• Low-grade fever

Diagnosing polymyalgia rheumatica

Your healthcare provider will ask about your health history and your symptoms. They will give you a physical exam. The exam will check your range of motion, strength, and painful areas.

Diagnosing PMR can be hard. Many different conditions can cause aching and stiffness. These include rheumatoid arthritis and fibromyalgia. So, your healthcare provider will need to confirm that you have PMR. To do that, you may need tests such as:

• Blood tests. These look for signs of inflammation, blood count problems, and muscle damage.

• X-rays. These look at your joints.

• MRI scan. This makes detailed pictures of your joints and tissues.

• Ultrasound. This looks most closely at the soft tissues around your joints.

Your healthcare provider may also diagnose you by giving you medicine. PMR often responds quickly to steroid medicine. This can help show if you have PMR. You may also be referred to a rheumatologist for diagnosis and treatment. A rheumatologist is a healthcare provider who is an expert in the diseases of the joints, muscles, and bones.

Some people with PMR can develop a condition called giant cell arteritis. This is an inflammatory disease that affects blood vessels. The most common symptoms are headache, face or scalp soreness, problems seeing, trouble chewing, fever, and tiredness. Call your healthcare provider right away if you have any of these symptoms.