Understanding Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory condition that can cause aching and stiffness. It tends to affect the neck, shoulders, and hips. The aching and stiffness are usually worse in the morning.

PMR can come on suddenly. For some it seems to occur overnight. For others it can take days or weeks to develop. PMR affects only older adults. It becomes more common with age. PMR occurs most often between the ages of 70 and 80. It is more common in women than in men, and it seems to run in some families.

What causes polymyalgia rheumatica?

Researchers are working to understand what causes PMR. Because it can happen quickly and tends to occur at certain times of year, some think that an infection may cause it. It may be related to immune system problems. Genes may be part of the cause. PMR can run in some families.

Symptoms of polymyalgia rheumatica

The main symptoms of PMR are aching and stiffness of the shoulders, neck, and hips. The aching can extend to the upper arms and thighs. PMR tends to affect both sides of the body equally. Symptoms are often worse in the morning or after long periods of no activity. Movement can make the pain worse.

The symptoms of PMR usually affect the shoulders the most. You may have trouble raising your arms above the level of your shoulders. This can make it hard to get dressed. You may have trouble rolling over in bed, getting out of bed, and getting up from sitting. You may also have trouble sleeping because of your symptoms.

Other symptoms can occur. These include:

  • Swelling of the hands, wrists, feet, and ankles

  • Numbness, tingling, or pain in the hand, wrist, or forearm

  • Feeling of weakness

  • General feeling of being unwell

  • Feeling tired

  • Loss of appetite

  • Weight loss

  • Low-grade fever

Diagnosing polymyalgia rheumatica

Your healthcare provider will ask about your health history and your symptoms. He or she will give you a physical exam. The exam will check your range of motion, strength, and painful areas.

Diagnosing PMR can be difficult. Your healthcare provider will need to make sure you have PMR. Many conditions can cause aching and stiffness. These include rheumatoid arthritis and fibromyalgia. You may need tests such as:

  • Blood tests to look for signs of inflammation, blood count problems, and muscle damage

  • Muscle biopsy to check for damage

  • Biopsy of a blood vessel in your temple

  • X-rays to look at your joints

  • MRI for detailed pictures of your joints and tissues

  • Ultrasound to look most closely at the soft tissues around your joints

Your healthcare provider may also diagnose you by giving you medicine. PMR often responds quickly to steroid medicine. This can help show if you have PMR. You may also be referred to a rheumatologist for diagnosis.