What is polymyalgia rheumatica?

In this article here, highly esteemed consultant rheumatologist, Dr Kirsten Mackay, details what polymyalgia rheumatica is, whilst also outlining the associated symptoms, causes, and treatment options. 

What is polymyalgia rheumatica?

Polymyalgia rheumatica (PMR) is an inflammatory disorder that primarily affects older adults, typically those over the age of 50. It is characterised by muscle pain and stiffness, particularly in the shoulders, neck, and hips. These symptoms can significantly impact daily activities and overall quality of life.

Symptoms

The most common symptoms of PMR include bilateral shoulder pain, morning stiffness lasting more than 30 minutes, and fatigue. Patients may also experience systemic symptoms such as low-grade fever, weight loss, and a general feeling of malaise. The pain often worsens with inactivity and improves with movement, which can be confusing for those unfamiliar with the condition.

Diagnosis

Diagnosing PMR can be challenging due to its similarity to other conditions like rheumatoid arthritis or fibromyalgia. A thorough medical history and physical examination are essential. Blood tests measuring inflammation markers, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), are commonly used to support the diagnosis. Imaging studies may also be employed to rule out other causes of joint pain.

Causes and risk factors

The exact cause of PMR remains unclear, but it is believed to involve an autoimmune response where the body’s immune system mistakenly attacks its own tissues. Genetic factors play a role; individuals of Northern European descent are at higher risk. Additionally, there is a notable association between PMR and giant cell arteritis, another inflammatory condition affecting blood vessels.

Treatment options

The primary treatment for PMR involves corticosteroids, which effectively reduce inflammation and alleviate symptoms. Most patients experience significant relief within days to weeks of starting treatment. Doctors typically begin with a low dose and gradually taper off as symptoms improve. Physical therapy may also be beneficial in maintaining mobility and strength.

Living with PMR

Managing PMR requires ongoing communication with healthcare providers to monitor symptoms and adjust treatment plans as necessary. Adopting a healthy lifestyle that includes regular exercise, a balanced diet, and stress management techniques can enhance overall well-being.