Polymyalgia rheumatica (PMR) is an inflammatory condition causing inflammation, pain, and stiffness of large muscles in the body such as the shoulder and hip muscles. The cause is still unknown, it mainly affects adults over 65 years of age, is rare under the age of 50, and females are more likely to experience it than men. In the UK around 1 in a 1,000 people develop PMR each year.
PMR is linked to - and can also occur alongside - a condition called giant cell arteritis (also known as temporal arteritis). This is another inflammatory condition that causes inflammation of the artery in your temple and can lead to changes to vision, headaches, scalp tenderness, and jaw pain.
The symptoms usually develop over a period of a few days or weeks and are typically worse in the morning, sometimes easing slightly through the day. They involve general aches and pains, muscle stiffness, and reduced movement in the muscles of the shoulders and hips. You may also get pain or stiffness in your elbows and knees too. This can greatly affect your ability to do simple daily functions like getting out of bed, getting dressed or brushing your hair. People may also experience more generalised symptoms of mild fever, tiredness, poor appetite, and low mood.
If you have new pain and stiffness that lasts longer than a week, is not related to an injury, and is affecting your sleeping or ability to carry out daily tasks and function, make an appointment to see your doctor.
Your doctor will take a history from you and do a physical examination, assessing your joints and nerves. They may organise further tests such as blood tests to rule out other conditions like rheumatoid arthritis, and also arrange further investigations to assess the severity of your disease such as an ultrasound scan of your muscles and joints.
A steroid tablet called prednisolone is the common medication used to reduce inflammation and treat symptoms and will be given at the lowest dose possible to gain the necessary response in symptoms. The aim is to use the steroid medication for the shortest amount of time because steroids have significant side effects - although it can be common to need steroids for a period of months to years when treating PMR. The steroid dose will be slowly weaned down when safe to do so, preventing your symptoms from returning.
In around a third of polymyalgia rheumatica cases, giant cell arteritis can develop. This is a serious medical emergency that can threaten eyesight. The symptoms to watch out for include double vision or loss of vision, severe headache, and tenderness to the scalp or jaw. If you have these symptoms, you should contact your doctor urgently for an on the day appointment or attend your local emergency department for review.
Read about Joint pain
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