Polymyalgia Rheumatica

Polymyalgia Rheumatica
Polymyalgia Rheumatica

Overview Of Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory disorder that causes pain and stiffness in the shoulders and the hips.

Commonly Associated With

PMR

Causes Of Polymyalgia Rheumatica

The causes of polymyalgia rheumatica remain unknown. It mostly occurs in people aged 50 and over.

PMR may precede or occur alongside giant cell arteritis.

PMR can sometimes be hard to differentiate from rheumatoid arthritis (RA) in older people. This happens when tests for rheumatoid factor and anti-CCP antibody come out negative.

Symptoms Of Polymyalgia Rheumatica

Pain and stiffness in both shoulders and the neck are the most common symptoms. These symptoms are worse in the morning. This pain often progresses to the hips.

Fatigue is also a symptom. People with this condition find it increasingly difficult to get out of bed and move around.

Other symptoms include:

  • Loss of appetite, which leads to weight loss
  • Fever
  • Depression

Exams & Tests

Lab tests can’t be relied on to diagnose PMR. People with this PMR have high inflammation markers, such as the sedimentation rate (ESR) and C-reactive protein.

Other test results include:

  • Abnormal protein levels in the blood
  • Anemia
  • Abnormal level of white blood cells

These tests can also monitor your condition.

However, imaging tests such as x-rays of the shoulder or hips are mostly unhelpful. They may reveal joint damage unrelated to recent symptoms.

In difficult cases, an ultrasound or MRI of the shoulder may be done. These imaging tests typically show low levels of joint inflammation or bursitis.

Treatment Of Polymyalgia Rheumatica

PMR does not get better without treatment. However, low doses of corticosteroids (such as prednisone, 10 to 20 mg per day) ease symptoms within a day or two.

The dose should be slowly reduced to a very low level afterwards.

Treatment must continue for 1 to 2 years. Longer treatment with low doses of prednisone is necessary for some people.

Corticosteroids cause many side effects such as weight gain, diabetes or osteoporosis. You need to be monitored closely if taking these medicines. If you are at risk for osteoporosis, your health care provider may recommend medication to prevent this condition.