What Is Polymyalgia Rheumatica?
Polymyalgia rheumatica is an inflammatory disorder that causes muscle
pain and stiffness in various parts of the body. It most commonly affects the:
The symptoms often appear suddenly and tend to be worse in the
Polymyalgia rheumatica typically affects people over age 65. It
rarely develops in those under age 50. Polymyalgia rheumatica is also more
likely to occur in women than in men. People of Northern European and
Scandinavian descent are at a higher risk for the condition as well.
Some people with polymyalgia rheumatica are also diagnosed with a
related disorder called temporal
arteritis. This condition causes inflammation of the blood vessels in the scalp,
neck, and arms. Temporal arteritis can also cause headaches, jaw pain, and vision
What Are the Symptoms of Polymyalgia Rheumatica?
Pain and stiffness in the neck and shoulders are the most common symptoms
of polymyalgia rheumatica. The pain and stiffness may gradually spread to other
areas, such as the shoulders, hips, and thighs. These symptoms usually affect
both sides of the body.
Other common symptoms of polymyalgia rheumatica include:
- a loss of appetite
- sudden, unintentional weight loss
- anemia, or low red blood
- a low-grade fever
- a limited range of motion
The symptoms of polymyalgia rheumatica develop quickly, usually over
several days. In some cases, the symptoms may appear overnight. They tend to be
worse in the morning and gradually improve throughout the day. For some people,
being inactive and remaining in one position for a long period of time can make
The pain and stiffness may eventually become so severe that
people have difficulty performing everyday activities, such as standing up from
the couch, getting dressed, or getting into a car. Sometimes, the symptoms of
polymyalgia rheumatica can even make it difficult to fall sleep.
What Causes Polymyalgia Rheumatica?
The cause of polymyalgia rheumatica isn’t known. However, it’s
believed that certain genes and gene variations may increase your risk of
developing polymyalgia rheumatica. Environmental factors may also play a role
in the development of the disorder. New cases of polymyalgia rheumatic are
often diagnosed in cycles and usually occur seasonally. This suggests that
there may be an environmental trigger, such as a viral infection, that causes
the condition. The rapid onset of symptoms also suggests that polymyalgia
rheumatica may be caused by an infection. However, no such link has been found.
How Is Polymyalgia Rheumatica Diagnosed?
The symptoms of polymyalgia rheumatica can be similar to those of
other inflammatory conditions, including lupus and arthritis. To make an
accurate diagnosis, your doctor will perform a physical exam and run several
tests to check for inflammation and blood abnormalities.
During the exam, your doctor may gently move your neck, arms, and
legs to evaluate your range of motion. If polymyalgia rheumatica is suspected,
they may order blood tests to check for signs of inflammation in your body.
These tests will measure your erythrocyte sedimentation rate and C-reactive
protein levels. An abnormally high sedimentation rate and elevated C-reactive
protein levels usually are suggestive of inflammation.
Your doctor may also schedule an ultrasound to check for
inflammation in your joints and tissues. An ultrasound uses high-frequency sound
waves to create detailed images of the soft tissue in different parts of the body.
This can be very helpful in distinguishing polymyalgia rheumatica from other
conditions that cause similar symptoms.
Since there’s a link between polymyalgia rheumatica and temporal
arteritis, your doctor may want to perform a biopsy. This biopsy is a simple,
low-risk procedure that involves the removal of a small sample of tissue from
an artery in your temple. The sample is sent to a laboratory and analyzed for
signs of inflammation. A biopsy is only necessary if your doctor suspects
inflammation in the blood vessels.
The signs of temporal arteritis include:
- persistent headaches
- blurred or double vision
- vision loss
- tenderness in the scalp
- jaw pain
How Is Polymyalgia Rheumatica Treated?
There’s no cure for polymyalgia rheumatica. With the proper treatment,
however, symptoms can improve in as little as 24 to 48 hours. Your doctor will
prescribe a low-dose corticosteroid, such as prednisone,
to help reduce inflammation. The typical dosage is 10 to 30 milligrams per day.
Over-the-counter pain medications, such as ibuprofen
aren’t effective in treating the symptoms of polymyalgia rheumatica.
Although corticosteroids are effective in treating polymyalgia
rheumatica, these drugs do have side effects. Long-term use of these
medications increases your risk of:
- high blood pressure
- high cholesterol
- weight gain
- diabetes or high levels of
sugar in the blood
- osteoporosis, which is
loss of bone density
which is clouding in the lens of the eye
To reduce your risk of having any side effects during treatment,
your doctor may recommend that you take a daily calcium and vitamin D
supplement. Supplements are often recommended if you’re taking corticosteroids
for more than three months. Your doctor may also suggest physical therapy to help
improve your strength and increase your range of motion.
Making healthy lifestyle choices can also help reduce the side
effects of corticosteroids. Eating a healthy diet and limiting your salt intake
can help prevent high blood pressure. Regular exercise can help strengthen your
bones and muscles and prevent weight gain.
Your doctor will carefully monitor your health during treatment. They
may periodically order blood tests to check your cholesterol and blood sugar
levels, recommend annual eye exams, and schedule periodic bone density tests to
check for signs of osteoporosis. Your doctor might also reduce your dosage
after three or four weeks of treatment if your symptoms are improving.
If your symptoms don’t improve with medication, then polymyalgia
rheumatica may not actually be the cause of your pain and stiffness. In this
case, your doctor will run additional tests to check for other rheumatic
disorders, such as osteoarthritis
and rheumatic fever.
What Are the Complications of Polymyalgia Rheumatica?
Polymyalgia rheumatica symptoms can interfere with everyday activities,
especially if the condition goes untreated. Without appropriate treatment, the
pain and stiffness can severely reduce mobility. You may eventually become
unable to complete simple tasks on your own, such as bathing, getting dressed,
and combing your hair. Some people also experience a temporary loss of joint
function. This increases the risk of developing lingering joint problems, such
People with polymyalgia rheumatica are also more likely to
develop peripheral artery disease. This condition impairs blood circulation and
often causes leg pain and ulcers.
What Is the Long-Term Outlook for Someone with Polymyalgia Rheumatica?
There’s no cure for polymyalgia rheumatica. However, polymyalgia
rheumatica often improves once treatment is received. In fact, the condition typically
goes away after two to six years of treatment.