An Introduction to Polymyalgia Rheumatica
Polymyalgia rheumatica (PMR) is a rheumatic disorder that is associated with moderate to severe muscle pain and stiffness in the neck, shoulder, and hip area. Stiffness is most noticeable in the morning. Polymyalgia rheumatica may develop rapidly -- in some patients, overnight. In other people, polymyalgia rheumatica develops more gradually.
Polymyalgia rheumatica is quite common. In the United States, it is estimated that 700 out of every 100,000 people over the age of 50 develop this disorder.
Causes of Polymyalgia Rheumatica
The cause of polymyalgia rheumatica is not known; however, possibilities include immune system abnormalities and genetic factors.
The fact that polymyalgia rheumatica is rare in people under the age of 50 suggests that it may be linked to the aging process. Also, about half of the people affected by
temporal arteritis (swelling of the arteries in the head, neck, and arms) also have polymyalgia rheumatica. At this point, though, researchers are not sure there is a direct connection between the two.
Polymyalgia Rheumatica and Temporal Arteritis
It is unclear how or why polymyalgia rheumatica and
temporal arteritis (also known as giant cell arteritis or cranial arteritis) are related, but an estimated 15 percent of people in the United States with polymyalgia rheumatica also develop temporal arteritis. Patients can develop temporal arteritis either at the same time as polymyalgia rheumatica or after the polymyalgia symptoms disappear.
When a person is diagnosed with polymyalgia rheumatica, the doctor also should look for
symptoms of temporal arteritis because of the risk of blindness that accompanies this condition. With proper treatment, temporal arteritis is not threatening. Untreated, however, temporal arteritis can lead to serious complications, including permanent vision loss and
stroke. Patients must learn to recognize the signs of temporal arteritis, because they can develop even after the symptoms of polymyalgia rheumatica disappear. Patients should immediately report any symptoms to their doctor.
Symptoms of Polymyalgia Rheumatica
Common symptoms of polymyalgia rheumatica include:
- Moderate to severe stiffness and muscle pain near the neck, shoulders, or hips
- Pain that is worse in the morning and after inactivity
- Flu-like symptoms, including fever
- Weakness
- Weight loss
- Fatigue
- Depression.
These possible symptoms of polymyalgia rheumatica are not sure signs of polymyalgia rheumatica. Other medical conditions can also cause these symptoms. People with possible symptoms of polymyalgia rheumatica should see their doctor so that the problem can be diagnosed and treated as quickly as possible.
Diagnosing Polymyalgia Rheumatica
No single test is available to diagnose polymyalgia rheumatica. To make a polymyalgia rheumatica diagnosis, a physician considers the patient's medical history, including symptoms that the patient reports, and results of laboratory tests, which can rule out other possible diagnoses.
Treatment for Polymyalgia Rheumatica
Polymyalgia rheumatica usually disappears without treatment in one to several years. With polymyalgia treatment, however, symptoms disappear quickly, usually in 24 to 48 hours. If there is no improvement, the doctor is likely to consider other possible diagnoses.
Treatment for polymyalgia rheumatica most often uses a corticosteroid medication, usually
prednisone. Polymyalgia rheumatica responds well to a low daily dose of prednisone.
Prognosis of Polymyalgia Rheumatica
The amount of time that polymyalgia treatment is needed is different for each patient. Most patients can discontinue their polymyalgia rheumatica medication after six months to two years. Once polymyalgia treatment is stopped, polymyalgia may recur; but again, symptoms usually respond rapidly to prednisone.
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