Polymyalgia rheumatica (PMR) is a disorder that causes severe stiffness and pain in the muscles of your neck, shoulders, and, less often, the lower back and hips.
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 whose ancestors are from Germany, Great Britain, or other northern European countries.
Symptoms may develop suddenly or gradually and include:
Your healthcare provider will ask about your symptoms and medical history and examine you. You may have lab tests and X-rays to check for other conditions that would cause your symptoms.
Although there is not a specific test for PMR, a blood test called ESR (erythrocyte sedimentation rate) may be done to check the diagnosis. The ESR helps diagnose conditions that cause inflammation. When you have polymyalgia rheumatica, the ESR is often 2 to 3 times higher than normal.
Between 10 and 15% of people with PMR also have a condition called temporal arteritis, or giant cell arteritis. When you have temporal arteritis, some of your arteries (usually the arteries on the sides of the face between the eye and the ear) become inflamed, narrowed, and sometimes completely blocked. The only way to diagnose temporal or giant cell arteritis is to do a biopsy of the temporal artery, which is located in front of each ear. After giving you local anesthesia, a surgeon will take a tiny piece of the artery wall to be examined for signs of arteritis.
Mild cases of PMR are sometimes treated with anti-inflammatory medicines such as aspirin or ibuprofen. These medicines are a type of medicine called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, don’t take NSAIDs for more than 10 days for any reason.
In most cases, medicines called steroids are needed to treat PMR. These medicines 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 the medicine. After a period of time you may be able to gradually stop taking the medicine. Your symptoms may come and go over years. Or they may be constant and you may need daily medicine.
If you also have arteritis, you may need a larger dosage of steroid medicine and your healthcare provider will follow you closely to prevent the complications of arteritis; which can include loss of vision in one of your eyes or a stroke.
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.
