Published: 18 Jun 2025

ICD9: 725      ICD10: M35.3      ICD11: FA22

Polymyalgia Rheumatica (PMR) is an inflammatory disorder that causes pain and stiffness in the muscles, especially around the shoulders and hips.
The term literally means "many muscle pain with rheumatism."

Here's a breakdown of key aspects of PMR:

Symptoms:
Pain and stiffness: This is the hallmark symptom, usually affecting both sides of the body. It's often most severe in the morning or after periods of inactivity.
Affected areas: Shoulders, hips, neck, upper arms, and thighs are the most common sites.
Limited range of motion: The pain and stiffness can make it difficult to move the affected joints.
Other symptoms: Fatigue, mild fever, general feeling of being unwell (malaise), loss of appetite, and unintentional weight loss.

Cause:
The exact cause of PMR is unknown.
It's thought to involve a combination of genetic predisposition and environmental factors that trigger an autoimmune response.

Risk Factors:
Age: It almost exclusively affects people over the age of 50, with the highest incidence in those over 70.
Gender: Women are more likely to develop PMR than men.
Ethnicity: It's more common in people of Northern European descent.

Diagnosis:
There's no single definitive test for PMR. Diagnosis is based on a combination of:
Symptoms: The characteristic pain and stiffness.
Physical exam: Assessing range of motion and tenderness.
Blood tests: An elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are common, indicating inflammation in the body. However, these are non-specific and can be elevated in other conditions.
Ruling out other conditions: Other conditions that can cause similar symptoms, such as rheumatoid arthritis, should be excluded.
Response to treatment: A rapid and significant improvement in symptoms with low-dose corticosteroids is often considered diagnostic.

Treatment:
Corticosteroids: Low-dose corticosteroids (such as prednisone) are the primary treatment. They are usually very effective in relieving symptoms quickly.
Tapering the dose: Once symptoms are controlled, the corticosteroid dose is gradually reduced over time to minimize side effects. This requires close monitoring by a doctor.
Calcium and Vitamin D supplements: Often prescribed to help prevent bone loss, which can be a side effect of long-term corticosteroid use.
Physical therapy: May be recommended to help maintain range of motion and strength.

Complications:
Giant Cell Arteritis (GCA): PMR is closely linked to giant cell arteritis, another inflammatory condition that affects the arteries, especially those in the head and neck. About 10-20% of people with PMR also develop GCA. Symptoms of GCA include headache, scalp tenderness, jaw pain, vision problems, and fever. GCA is a serious condition that can lead to blindness or stroke if left untreated, so it's important to be aware of its symptoms.
Side effects of corticosteroids: Long-term corticosteroid use can lead to a variety of side effects, including weight gain, high blood pressure, diabetes, osteoporosis, cataracts, and increased risk of infection.

Prognosis:
With proper treatment, most people with PMR experience significant improvement in their symptoms.
Treatment typically lasts for 1-2 years, or sometimes longer.
Relapses can occur, requiring adjustments to the medication.

In summary, Polymyalgia Rheumatica is an inflammatory condition causing pain and stiffness in the shoulder and hip areas, primarily affecting older adults. It's treated with corticosteroids, and while the long-term prognosis is generally good, it's important to be aware of potential complications, particularly Giant Cell Arteritis.

Disclaimer: This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.