About polymyalgia rheumatica

What is polymyalgia rheumatica?

Polymyalgia rheumatica and giant cell arteritis facts

  • Polymyalgia rheumatica causes pain and stiffness in muscles and joints.
  • Polymyalgia rheumatica is diagnosed by characteristic symptoms associated with abnormal blood testing for inflammation.
  • Polymyalgia rheumatica is treated with low doses of cortisone medications.
  • Giant cell arteritis is a result of inflammation of arteries.
  • Giant cell arteritis can lead to blindness and/or stroke.
  • Giant cell arteritis is detected by a biopsy of an artery.
  • Giant cell arteritis is treated with high-dose cortisone medications.

What is polymyalgia rheumatica?

Polymyalgia rheumatica is a disorder of the muscles and joints characterized by muscle pain and stiffness, affecting both sides of the body, and involving the shoulders, arms, neck, and buttock areas. Patients with polymyalgia rheumatica are typically over 50 years of age. Polymyalgia rheumatica is abbreviated PMR.

Because both polymyalgia rheumatica and giant cell arteritis sometimes occur in the same patient, both diseases are reviewed here.

What are the symptoms for polymyalgia rheumatica?

The signs and symptoms of polymyalgia rheumatica usually occur on both sides of the body and might include:

You might also have more-general signs and symptoms, including:

  • Mild fever
  • Fatigue
  • A general feeling of not being well (malaise)
  • Loss of appetite
  • Unintended weight loss
  • Depression

When to see a doctor

See your doctor if you have aches, pains or Stiffness that:

  • Is new
  • Disrupts your sleep
  • Limits your ability to do your usual activities, such as getting dressed

What are the causes for polymyalgia rheumatica?

The exact cause of polymyalgia rheumatica is unknown. Two factors appear to be involved in the development of this condition:

  • Genetics. Certain genes and gene variations might increase your susceptibility.
  • An environmental exposure. New cases of polymyalgia rheumatica tend to come in cycles, possibly developing seasonally. This suggests that an environmental trigger, such as a virus, might play a role. But no specific virus has been shown to cause polymyalgia rheumatica.

Giant cell arteritis

Polymyalgia rheumatica and another disease known as giant cell arteritis share many similarities. Many people who have one of these diseases also have symptoms of the other.

Giant cell arteritis results in inflammation in the lining of the arteries, most often the arteries in the temples. Signs and symptoms include headaches, jaw pain, vision problems and scalp tenderness. If left untreated, this condition can lead to stroke or blindness.

What are the treatments for polymyalgia rheumatica?

The treatment of polymyalgia rheumatica is directed toward reducing inflammation. While some patients with mild symptoms can improve with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen (Motrin, Advil), most patients respond best to low doses of cortisone medications (steroid medications, such as prednisone or prednisolone). Not infrequently, a single day of cortisone medication eases many of the symptoms! In fact, the rapid, gratifying results with low dose cortisone medications is characteristic of polymyalgia rheumatica.

The dose of prednisone 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. Most patients are able to completely wean from prednisone within several years. Some patients require longer-term treatment. Occasionally, patients have recurrence years after the symptoms have resolved. The ideal prednisone dosing regimen continues to be sought by researchers.

What are the risk factors for polymyalgia rheumatica?

Risk factors for polymyalgia rheumatica include:

  • Age. Polymyalgia rheumatica affects older adults almost exclusively. It most often occurs between ages 70 and 80.
  • Sex. Women are about two to three times more likely to develop the disorder.
  • Race. Polymyalgia rheumatica is most common among white people whose ancestors were from Scandinavia or northern Europe.

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