Polymyalgia Rheumatica

Polymyalgia Rheumatica (PMR) is an inflammatory autoimmune disease that causes stiffness and aching in large muscle groups, especially around the shoulders, neck, upper arms, hips, and thighs. It typically develops suddenly in people over age 50, and symptoms are often worse in the morning or after inactivity. Unlike muscle diseases like polymyositis, PMR does not cause muscle weakness - only pain and stiffness. It is closely linked to Giant Cell Arteritis (GCA), and both conditions may occur together.

Aching and stiffness in shoulders, upper arms, hips, or thighs; Morning stiffness lasting more than 30 minutes; Pain that improves with movement but returns at rest; Difficulty getting out of bed, dressing, or raising arms; Fatigue; Mild fever, weight loss, or loss of appetite; Depression or mood changes due to chronic discomfort.

Exact cause is unknown, but believed to be an autoimmune condition where the immune system triggers inflammation in the linings of joints and tissues. Contributing factors: Age-related immune changes (rare before age 50); Genetics (certain HLA gene variants); Environmental triggers, including seasonal infections.

Blood tests: Elevated CRP and ESR; Rule out other conditions like rheumatoid arthritis, fibromyalgia, or infection; Physical exam for stiffness and range of motion; Improvement with a trial of low-dose corticosteroids often confirms diagnosis.

Low-dose corticosteroids (e.g., prednisone) - usually brings quick symptom relief; Gradual tapering over months to years; Calcium and vitamin D supplements to protect bones; Bone density monitoring for steroid side effects; NSAIDs or physical therapy may support recovery.

Most people improve significantly with treatment. PMR may last 1 to 2 years, sometimes longer. Regular follow-up is important to adjust steroid doses and prevent relapse. About 10-20% of people with PMR also develop Giant Cell Arteritis.

Affects about 700 per 100,000 people over age 50. One of the most common inflammatory diseases in older adults. More common in women and those of Northern European descent.