What Is 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. The condition may develop rapidly -- in some people, it can occur overnight. In other people, polymyalgia rheumatica develops more gradually.
Causes of Polymyalgia Rheumatica
The cause of polymyalgia rheumatica is not known; however, possibilities include immune system abnormalities and genetic factors.
The fact that the condition 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. People 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, it can lead to serious complications, including permanent vision loss and
stroke. People must learn to recognize the signs of temporal arteritis, because they can develop even after the symptoms of polymyalgia rheumatica disappear. Any possible symptoms should be reported immediately to a healthcare provider.
Symptoms of Polymyalgia Rheumatica
- 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 are not sure signs of polymyalgia rheumatica. Other medical conditions can also cause these symptoms. People with possible symptoms should see their healthcare provider 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 diagnosis, a physician considers the person's medical history, including reported symptoms, 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 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.
Prognosis of Polymyalgia Rheumatica
The amount of time that polymyalgia treatment is needed is different for each person. Most people can discontinue their medication after six months to two years. Once treatment is stopped, polymyalgia may recur; but again, symptoms usually respond rapidly to prednisone.
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