Polymyalgia Rheumatica (PMR)
Polymyalgia rheumatica is an inflammatory disorder that causes aching and stiffness in your muscles and joints. Sometimes, PMR leads to a more dangerous condition (temporal arteritis or giant cell arteritis), which can cause vision loss.
6 Interesting Facts of Polymyalgia Rheumatica
1. Polymyalgia rheumatica (PMR) is a common inflammatory disorder in the elderly.
2. Patients present with subacute onset of severe pain and stiffness in proximal limbs without objective weakness associated with a high erythrocyte sedimentation rate (ESR).
3. PMR may precede or coincide with the diagnosis of giant cell arteritis (GCA) in a significant number of patients.
4. Patients should respond dramatically within a week of initiation of 20 mg/day of prednisone.
5. The presence of fever, failure to respond to prednisone clinically, and/or persistently high ESR on therapy suggests the need for further evaluation to rule out GCA or another diagnosis (e.g., malignancy or infection).
6. PMR treatment often lasts ≥2 years and relapses are frequent.
Where did the term Polymyalgia Rheumatica originate?
The name PMR was first published by Barber in 1957 in a report of 12 patients with proximal myalgias.
What are the causes?
The exact cause of PMR is not known.
What increases the risk of Polymyalgia Rheumatica?
This condition is more likely to develop in:
- People who are 50 years of age or older.
What are the symptoms of Polymyalgia Rheumatica?
Pain and stiffness are the main symptoms of PMR. Symptoms may start slowly or suddenly. The symptoms:
- May be worse after inactivity and in the morning.
- May affect your:
- Hips, buttocks, and thighs.
- Neck, arms, and shoulders. This can make it hard to raise your arms above your head.
- Hands and wrists.
Other symptoms include:
- Decreased appetite. This may lead to weight loss.
How is Polymyalgia Rheumatica diagnosed?
This condition is diagnosed with a medical history and physical exam. You may need to see a health care provider who specializes in diseases of the joint, muscles, and bones (rheumatologist). You may also have tests, including:
- Blood tests.
How is Polymyalgia Rheumatica treated?
PMR usually goes away without treatment, but it may take years for that to happen. In the meantime, your health care provider may recommend low-dose steroids to help manage your symptoms of pain and stiffness. Regular exercise and rest will also help your symptoms.
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Make sure to get enough rest and sleep.
- Eat a healthy and nutritious diet.
- Try to exercise most days of the week. Ask your health care provider what type of exercise is best for you.
- Keep all follow-up visits as told by your health are provider. This is important.
Contact a health care provider if:
- Your symptoms are not controlled with medicine.
- You have side effects from steroids. These may include:
- Weight gain.
- Mood changes.
- High blood sugar readings, if you have diabetes.
- Higher than normal blood pressure readings, if you monitor your blood pressure.
Get help right away if:
- You develop symptoms of temporal arteritis, such as:
- A change in vision.
- Severe headache.
- Scalp pain.
- Jaw pain.