Polymyalgia rheumatica
Polymyalgia rheumatica (PMR) is an inflammatory condition causing inflammation, pain, and stiffness of large muscles of the body such as the shoulder and hip muscles. PMR mainly affects adults over 65 years of age, and females are more likely to experience it than men. The cause of PMR is largely unknown, but genetics and environmental factors are said to play a part.
PMR is linked to and can also occur alongside a condition called giant cell arteritis (also known as temporal arteritis). This is another inflammatory condition that causes inflammation of the artery in your temple and can lead to changes in vision, headaches, scalp tenderness, and jaw pain.
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What are the symptoms of polymyalgia rheumatica?
The symptoms usually begin quite quickly and are worse in the morning, typically lasting longer than 45 minutes. The symptoms involve general aches and pains, stiffness, and reduced movement in the muscles of the shoulders and hips. You may get pain or stiffness in your elbows and knees, too.
This can greatly affect your ability to do simple daily functions like getting out of bed or getting dressed. People may experience more generalized symptoms of mild fever, tiredness, poor appetite, and low mood.
When should I see my doctor?
If you have new pain and stiffness that lasts longer than a week, is not related to an injury, and is affecting your sleeping or ability to carry out daily tasks and function, then it is worth booking an appointment to see your doctor.
Your doctor will take a history from you and do a physical examination, assessing your joints and nerves. They may organize further tests like blood tests to rule out other conditions like rheumatoid arthritis and further investigations to assess the severity of your disease - like an ultrasound scan of your muscles and joints.
How is polymyalgia rheumatica treated?
A steroid tablet called prednisone is the most common medication used to reduce inflammation and treat symptoms. This will be given at the lowest dose possible to gain the necessary improvement in symptoms. The aim is to use the steroid medication for the shortest amount of time because steroids have significant side effects - although it can be common to need steroids for a period of months to years. The steroid dose will be slowly weaned down when safe to do so, preventing your symptoms from returning.
Watching out for giant cell arteritis
In around a third of polymyalgia rheumatica cases, the previously mentioned giant cell arteritis can develop.
This is a serious medical emergency that can threaten eyesight.
The symptoms to watch out for include double vision or loss of vision, severe headache, and tenderness to the scalp or jaw. If you have these symptoms, you should contact your doctor urgently for a same-day appointment or go to your local emergency department for review.
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