Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness. Signs and symptoms of polymyalgia rheumatica usually begin quickly and are worse in the morning. Most people who develop polymyalgia rheumatica are older than 65. This condition is related to another inflammatory called giant cell arteritis. Giant cell arteritis can cause headaches, vision difficulties, jaw pain and scalp tenderness. It's possible to have both conditions together.
Pain and stiffness in the neck and shoulders are the most common symptoms of polymyalgia rheumatica. The pain may gradually spread to other areas, such as the shoulders, hips, and thighs. Common symptoms of polymyalgia rheumatica include:
- a loss of appetite
- sudden weight loss
- anemia, or low red blood cell count
- a limited range of motion
While the causes of PMR are not well understood, there are many theories as to its cause. It is suggested that the condition is the result of inflammation in the joints and the sacs surrounding the joints known as the bursae. This inflammation may lead to referred pain in other parts of the body. For instance, if the shoulder and hip joints are affected, pain may be experienced in the upper arms and thighs. While there is no definitive evidence, PMR could also result from an infection. Additional research is needed to determine the causes associated with PMR.
The symptoms of polymyalgia rheumatica can be similar to those of other inflammatory conditions, including lupus and arthritis. To make an accurate diagnosis, your doctor will perform a physical exam and run some tests to check for inflammation and blood abnormalities. If polymyalgia rheumatica is suspected, they may order blood tests to check for signs of inflammation in your body. These tests will measure your erythrocyte sedimentation rate and C-reactive protein levels. An abnormally high sedimentation rate and elevated C-reactive protein levels usually are suggestive of inflammation. Your doctor may also schedule an ultrasound to check for inflammation in your joints and tissues. This can be very helpful in distinguishing polymyalgia rheumatica from other conditions that cause similar symptoms.
Doctors direct their medical treatment of PMR toward reducing pain and inflammation. While some patients with mild symptoms can improve with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, most patients respond best to low doses of corticosteroids. Not infrequently, a single day of cortisone medicine eases many of the symptoms! In fact, gratifying results with low dose corticosteroids is characteristic of the condition. The corticosteroid dose is gradually reduced while the doctor monitors the symptoms and normalization of the blood ESR. Reactivation of symptoms can require periodic adjustments in the prednisone dosage. Normally, some patients require longer-term medical treatment. Sometimes, patients have recurrence years after the symptoms have resolved. The ideal prednisone dosing regimen continues to be sought by clinical researchers.
There’s no cure for polymyalgia rheumatica. However, polymyalgia rheumatic can often improve once treatment is received. In fact, the condition typically goes away after two to six years of treatment. Even though you'll start to feel better soon after you begin treatment, it can be very frustrating having to take medication daily, especially one that can cause such serious side effects. Ask your health care team what steps you can take to stay healthier while you're taking corticosteroids. Your doctor might also know of local support groups in your area. Talking to others who are living with the same illness and challenges can be helpful.