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Polymyalgia rheumatica

Polymyalgia rheumatica is an inflammatory disorder that results in muscular pain and stiffness, particularly in the muscles of the hips, upper arms, shoulders and neck. 

Polymyalgia rheumatica

Not much is understood about the causes of polymyalgia rheumatica, but it’s thought that some people may have a genetic predisposition towards the condition or that it may have an environmental trigger – possibly some sort of infectious disease. 

What is known is that it occurs most frequently in the elderly and is less common in men than in women. Polymyalgia rheumatica has also been linked to temporal arteritis (also called giant cell arteritis), with up to 20% of sufferers exhibiting signs of this condition too.

What are its symptoms?

Polymyalgia rheumatica symptoms include:

  • The primary symptom is muscle pain and stiffness that ranges from moderate to severe in the upper arms, shoulders, neck, thighs, buttocks and hips. Pain is usually worse in the morning or after sleeping and tends to last more than 45 minutes.
  • Reduced range of motion in those areas affected
  • Weakness and extreme exhaustion
  • Diminished appetite and weight loss
  • Occasional low-grade fever

How is it diagnosed? 

A polymyalgia rheumatica diagnosis is not always easy as it can be challenging to discern whether a patient is suffering from polymyalgia rheumatic or rheumatoid arthritis. Because the conditions share very similar symptoms, in some cases the diagnosis may end up being reconsidered once treatment has already started. 

There is no specific test for the condition, so usually diagnosis will be based on a physical examination, blood tests (while not definitive, an erythrocyte sedimentation rate test and C-reactive protein test can give an indication of the presence of inflammation) and imaging tests like X-ray, which can help rule out similar conditions.

What are your treatment options? 

There is no cure for polymyalgia rheumatica at present. Polymyalgia rheumatica treatment focuses on relieving the symptoms of the condition. 

Oral corticosteroids are the gold standard in treatment: usually patients will be started off on a high dose, which can provide relief from pain and stiffness within a few days, and will then be lowered gradually over the course of months. It is important to take steroidal medications exactly as prescribed and to report any side effects to your healthcare provider. 

Over time symptoms may abate altogether but it is possible to relapse after treatment has ended. 

Can it be prevented? 

As much still remains to be understood about this condition, what causes it and the risk factors that may lead to its development, the prevention of polymyalgia rheumatica is not yet possible.

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016