Polymyalgia rheumatica

Definition

Polymyalgia rheumatica (PMR) is an inflammatory disorder involving pain and stiffness in the shoulder and usually also the hip.

Causes

Polymyalgia rheumatica is a disorder that almost always occurs in people over 50 years old. The cause is unknown.

PMR may occur alone, or with or before giant cell arteritis (also called temporal arteritis), which is inflammation of blood vessels (usually in the head).

Symptoms

The most typical symptom is pain and stiffness in both shoulders and the neck. This pain usually progresses to the hips, and there isfatigue too. It becomes more and more difficult for patients to get around.

Other symptoms include:

• Anemia
• Appetite loss, which leads to unintentional weight loss
• Depression
• Fever

There are no specific joint symptoms.

Some people with PMR also have giant cell arteritis. This far more serious disease can cause:

• Heart attack
• Stroke
• Sudden blindness

Exams and Tests

Lab tests cannot diagnose polymyalgia rheumatica. However, most patients with this condition have an elevated sedimentation rate (ESR), a blood test that can show certain kinds of inflammation.

Other test results for this condition (as well as for giant cell arteritis) include:

• Abnormal proteins in the blood
• Abnormal white blood cells
• Reduced hemoglobin and hematocrit
• Signs of anemia

These tests may also be used to monitor patients' progress.

Treatment

Although there is no cure for polymyalgia rheumatica, treatment can help prevent patients from becoming disabled.

Low doses of corticosteroids (such as prednisone) can relieve polymyalgia rheumatica within a day or two. The dose can then be slowly reduced to a very low level, but the treatment will need to continue for a long time -- around 2 - 6 years.

Corticosteroids cause a variety of side effects that must be carefully monitored and managed.

Outlook (Prognosis)

Polymyalgia rheumatica usually goes away by itself after 2 - 6 years. After this time, treatment can be stopped.

Possible Complications

Polymyalgia rheumatica can cause serious disabilities if untreated.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have persistent weakness or stiffness of the shoulder and neck area, especially if you also have symptoms of general illness, such as fever or headache.

Prevention

There is no known prevention.

References

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