What is Polymyalgia Rheumatica?
Polymyalgia rheumatica (PMR) is an inflammatory condition that causes pain and stiffness in the shoulders, neck, upper arms, hips, and thighs. It almost exclusively affects people over 50 and is more common in women. PMR is one of the most common inflammatory conditions in older adults and, if treated promptly, usually responds very well to corticosteroid treatment.
Symptoms
- Aching and stiffness in the shoulders, neck, upper arms, hips, and thighs
- Morning stiffness lasting more than 45 minutes
- Difficulty raising arms above shoulder height
- Difficulty getting up from a chair
- Fatigue
- Low-grade fever
- Unintentional weight loss
Diagnosis
Diagnosis is based on symptoms, age, and blood tests showing raised inflammatory markers (CRP and ESR). Other conditions (such as rheumatoid arthritis, myositis, and cancer) must be excluded first.
Link to Giant Cell Arteritis
About 15–20% of people with PMR also develop giant cell arteritis (GCA) — a serious inflammation of the arteries, particularly those supplying the eyes and brain. GCA can cause sudden vision loss and stroke. Symptoms of GCA include severe headache, jaw pain when chewing, scalp tenderness, and vision problems — these require urgent medical attention.
Treatment
PMR responds dramatically to low-dose prednisolone (a corticosteroid). Most people feel significantly better within days of starting treatment. Treatment usually continues for 1–2 years and is gradually tapered. Bone protection (calcium, vitamin D, and bisphosphonates) is important during long-term steroid use.