Polymyalgia Rheumatica
What is it?
Polymyalgia rheumatica (PMR) is a condition
that causes severe pain and stiffness in the neck,
shoulder, and hip muscles. The lower back may also
be affected.
Who gets it?
Polymyalgia rheumatica most commonly affects
people over the age of 50. It is more likely to
occur in women than men, and is more common in
people whose ancestors are from Germany,
Scandinavia, or other northern European countries.
The average age at diagnosis is 70.
What causes it?
The cause of polymyalgia rheumatica is unknown.
However, there appears to a tendency to inherit
this disease.
What are the symptoms?
Symptoms of polymyalgia rheumatica include pain
and stiffness in the muscles of the neck,
shoulders, and hips, which can spread to the upper
arms, lower back, and thighs. Pain is generally
worse upon first waking in the morning or with
inactivity, and may come on suddenly or develop
gradually. Other symptoms can include a low fever,
weight loss, fatigue, and depression. Some people
with polymyalgia rheumatica may also have temporal
arteritis, which is also called giant cell
arteritis. Temporal arteritis most commonly
affects the temporal arteries, which run from the
carotid artery in the neck along the temples in
the head. People with temporal arteritis will have
additional symptoms of dull headache, jaw pain,
and a scalp that is sensitive to the touch in the
affected area. While polymyalgia rheumatica
usually does not cause weakness or muscle damage,
there are patients whose pain is so severe that
they avoid moving the affected muscles, causing
the muscles to waste away, or atrophy, from
disuse.
How is it diagnosed?
Your doctor will make a diagnosis of
polymyalgia rheumatica based upon a description of
your symptoms, a complete medical history, and a
thorough physical examination. Your doctor will
order blood tests to check for signs of anemia,
which may be present with polymyalgia rheumatica,
and to check your erythrocyte sedimentation rate.
This is the rate at which the red blood cells sink
to the bottom of a test tube. The erythrocyte
sedimentation rate is usually high in people with
the inflammation characteristic of polymyalgia
rheumatica. Because this rate is also high in
people with temporal arteritis, your doctor will
look for signs of a swollen, inflamed artery in
the temple or scalp.
What is the treatment?
Polymyalgia rheumatica is treated with low
doses of corticosteroid drugs, such as prednisone.
Where temporal arteritis is also diagnosed, the
dosage is higher. The usual course of this disease
is anywhere from two to four years. Over that
time, the dosage is gradually decreased until it
is no longer needed. Milder cases of polymyalgia
rheumatica can be treated successfully with
aspirin or non-steroidal anti-inflammatory drugs (NSAIDs),
such as ibuprofen. NSAIDs are great for reducing
pain and inflammation, and may also be used in
conjunction with corticosteroid drugs in more
severe cases. You will require periodic blood
tests to monitor your treatment and to make sure
the disease does not recur.
Self-care tips
See your doctor as soon as possible if you have
any symptoms of polymyalgia rheumatica. Follow the
recommended treatment exactly as prescribed. If
you also have temporal arteritis, notify your
doctor immediately if you notice any vision
changes during treatment.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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