Polymyalgia Rheumatica

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KEY POINTS

• Polymyalgia rheumatica (PMR) is a disorder that causes severe stiffness and pain in the muscles of your neck, shoulders, and, less often, your lower back and hips.
• PMR is treated with steroid medicine. This medicine can relieve symptoms in days to weeks. With treatment, the condition typically lasts about 2 years. Symptoms may come back months or years later, however.
• Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider how long it will take to recover.

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What is polymyalgia rheumatica?

Polymyalgia rheumatica (PMR) is a disorder that causes severe stiffness and pain in the muscles of your neck, shoulders, and, less often, your lower back and hips.

What is the cause?

The cause of this disorder is not known. It generally affects people over age 50. Women are affected more often than men. Some researchers believe that PMR may be inherited. It is more common among people of northern European ancestry.

What are the symptoms?

Symptoms may include:

• Stiffness and pain in the muscles of your neck, shoulders, upper arms, lower back, thighs, and hips that is often worse in the morning
• A slight fever
• Feeling tired
• Weight loss
• Depression

Some people with PMR also have a condition called temporal arteritis, or giant cell arteritis. This condition causes some of your arteries (usually those on the sides of your face between your eye and ear) to get swollen, narrowed, and sometimes completely blocked. The symptoms of giant cell arteritis are a tender scalp, headaches, vision problems, and jaw pain.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• A biopsy, which is the removal of a small sample of tissue for testing (if your provider thinks that you may also have giant cell arteritis)
• X-rays

How is it treated?

PMR is treated with steroid medicine. This medicine can relieve symptoms in days to weeks. Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider's approval. You may have to lower your dosage slowly before stopping it.

Sometimes symptoms may be relieved completely with medicine. With treatment, the condition typically lasts about 2 years. Symptoms may come back months or years later, however. Then you will need to treat the problem again with medicine.

If you also have arteritis, your healthcare provider will follow you closely to prevent problems such as loss of vision in one of your eyes or a stroke.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.