Polymyalgia Rheumatica: Symptoms, Treatment

Overview

Polymyalgia rheumatica (PMR) is a common inflammatory disease that can cause pain and stiffness in the muscles and joints. The most susceptible areas of the body are shoulders, neck, arms and, hips. It usually occurs with another health condition, giant cell arteritis. Signs and symptoms of the disorder often begin quickly and are particularly worse in the morning.

PMR is more common in people older than 65. It rarely affects people under 50 years old. Caucasians are usually at a higher risk of developing the disease. The cause of PMR is unknown, but fortunately, we do have proper treatment options for it now.

Cause

We don’t know what causes PMR exactly. Recent studies show that certain genes or gene variations may increase your risk of developing PMR.

Environmental factors, such as infections, also play a role in the disease. Since people under 50 years old are less likely to be affected, older age may be another risk factor for the condition.

Symptoms

The most common signs and symptoms of PMR are pain and stiffness in the muscle and joints, mostly in your neck and shoulders. The symptoms may gradually spread to other areas, such as hips, and thighs. In addition, common symptoms of PMR include:

  • Fatigue
  • Weakness
  • Loss of appetite
  • Weight loss
  • Depression
  • Mild fever in some cases
  • A limited range of motion
  • A general feeling of being ill

Diagnosis

PMR is hard to recognize because it does not often cause swollen joints. Your doctor will first do physical and neurological exams, to determine the cause of your pain and stiffness. During the exam, the doctor might gently move your head and limbs to assess your range of motion. Tests that can be helpful include:

  • Blood tests

Besides checking your complete blood counts (CBCs), your doctor will look for two indicators of inflammation — erythrocyte sedimentation rate (sed rate or ESR) and C-reactive protein (CRP). However, not everyone with PMR has elevated levels in the test results.

  • Imaging tests

Ultrasound is used increasingly to distinguish PMR from other conditions that can cause similar symptoms. MRI can help in identifying other causes of shoulder pain, such as joint changes.

Apart from diagnosing PMR, your doctor may also monitor you for signs and symptoms that can indicate the onset of giant cell arteritis, because about 10-15% of patients with PMR would develop giant cell arteritis. Tell your doctor immediately if you have any of the following symptoms:

  • New, unusual or persistent headaches
  • Jaw pain or tenderness
  • Blurred or double vision or visual loss
  • Scalp tenderness

If your doctor suspects you might have giant cell arteritis, he or she will conduct a biopsy of the artery in one of your temples.

Treatment

The treatment options for PMR target towards reducing pain and inflammation and easing stiffness, fatigue and, fever. A combination of medication and lifestyle change may help.

Medications that can be used include:

Low-dose corticosteroids are the most common and effective medication used for treating PMR. Often, the dose is 10–15 milligrams per day of prednisone (Deltasone, Orasone, etc.). The medicine can relieve pain and stiffness in the first two or three days.

  • Calcium and vitamin D supplements

Daily doses of calcium and vitamin D supplements can help prevent bone loss induced by corticosteroid treatment.

This is an immune-suppressing medication taken by mouth. It may be useful in the early course of treatment or later, if you relapse or don’t respond to corticosteroids.

Healthy lifestyle choices can help you manage the side effects that may result from corticosteroid use. These choices include:

  • Eat a healthy diet
  • Exercise regularly
  • Have enough rest

Keyword: polymyalgia rheumatica (PMR).

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.