Definition

Polymyalgia rheumatica (PMR) is an inflammatory disorder. It results in muscle pain and stiffness in the body. The effects are most common in the shoulders, arms, hips, and thighs. About 15% of people with PMR will also develop giant cell arteritis (GCA). GCA is an inflammation of the lining of the arteries, the blood vessels that carry blood away from the heart.

Causes

The exact cause is not known. Inflammatory conditions may be due to some problem with the immune system. Some evidence suggests that certain viruses could be responsible for PMR. Genetic factors may also play a role.

Risk Factors

PMR is most common in Caucasian women, aged 65 years and older.

Symptoms

Symptoms may include:

• Muscle pain and/or stiffness in the hip, shoulder, or neck areas
• Stiffness in the morning
• Fever
• Unexplained weight loss
• Fatigue
• Mood changes

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

• Blood tests
• Muscle biopsy

Images may be taken of your bodily structures. This can be done with:

• CT scan
• MRI scan

Treatment

Symptoms of PMR will disappear without treatment within several months to years. Treatment leads to dramatic improvement, which may occur within 24-48 hours.

Treatment may include:

• Anti-inflammatory medications
• Corticosteroids
• Supplements, such as calcium or vitamin D
• Physical therapy to help with strength, flexibility, and mobility

Prevention

There are current guidelines to prevent PMR.

Arthritis Foundation http://www.arthritis.org

Health Canada http://www.hc-sc.gc.ca

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Matteson EL, Gold KN, et al. Long-term survival of patients with giant cell arteritis in the American College of Rheumatology Giant Cell Arteritis classification criteria cohort. Am J Med. 1996;100:193.

Polymyalgia rheumatica. American College of Rheumatology website. Available at:
http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/polymyalgiarheumatica.asp
Updated February 2013. Accessed June 29, 2015.

Polymyalgia rheumatica (PMR). EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated July 8, 2014. Accessed June 29, 2015.

Questions and answers about polymyalgia Rheumatical and giant cell arteritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at:
http://www.niams.nih.gov/Health_Info/Polymyalgia/default.asp
Updated August 2012. Accessed June 29, 2015.

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Soubrier M, Dubost JJ, et al. Polymyalgia rheumatica: diagnosis and treatment. Joint Bone Spine. 2006;73(6):599-605. Review.