What is polymyalgia rheumatica?

Polymyalgia rheumatica causes pain and swelling in joints and muscles, mainly in the hips, neck, and shoulders. Pain and swelling may be worse in the morning. This condition can occur quickly and often lasts for a year or two. Your doctor will treat you with medicine to reduce swelling. Your symptoms should get much better in 1 to 3 days and go away in 2 to 4 weeks.

Some people who have this also get giant cell arteritis (temporal arteritis). This causes swelling of some blood vessels in the head. Tell your doctor if you have any headaches, jaw pain, or tightness or tenderness along the temple or scalp. This condition can cause blindness if it is not treated. Tell your doctor if you have problems with your vision, including blurring or seeing double.

Symptoms often start suddenly and get worse without treatment. The most common symptoms are muscle pain and stiffness in the neck, shoulders, or hips. These symptoms are worse in the morning. And they affect both sides of the body–for example, both shoulders, not just one.

Other symptoms may include:

• Tiredness and lack of energy.
• Fever.
• Weight loss.
• Swelling in the knees, wrists, or ankles.

PMR is treated with steroid medicines, which reduce inflammation. You'll probably feel better in a day or two after you start the medicine. Most of the time, symptoms improve quickly and go away 2 to 4 weeks after treatment begins. But you may need to keep taking steroid medicine for 1 to 2 years or even longer. This helps to keep your symptoms from coming back.

In some people, symptoms improve with treatment but then come back. This is called a relapse. It often occurs in the first 2 years of treatment or during the first year after steroid medicine is stopped. Your doctor will track your condition during this time. If you have a relapse, your doctor will increase your steroid dosage for a while. Then you can slowly lower it after your symptoms go away.

Long-term treatment with steroid medicine will put you at risk for bone thinning (osteoporosis). This is because steroid medicines reduce how well your body takes in calcium, which is important in building strong bones. Your doctor may recommend a bone density test to see if you need medicine to prevent osteoporosis. These medicines are called bisphosphonates. Or your doctor may start you on the medicine without the test.

Your doctor may also suggest that you take medicine to help protect your digestive tract, such as a proton pump inhibitor or an H2 blocker. Taking medicines like steroids for a long time can irritate your esophagus and stomach and lead to ulcers. Proton pump inhibitors and H2 blockers help reduce this irritation.

Your doctor will do a physical exam and ask you about your symptoms and past health. For example, the doctor may look for pain and stiffness in your shoulders, which may be a sign of PMR.

The doctor will also consider your age in diagnosing this condition. People younger than 50 very rarely have PMR.

Your doctor may order tests too. These may include:

• Blood tests such as sedimentation rate and C-reactive protein. These tests can show if you have inflammation in your body.
• Complete blood count. This test can show if you have anemia, which is common in people who have PMR.

Some other conditions can cause similar symptoms. Your doctor may also do tests to rule out those conditions, which include arthritis and hypothyroidism.

If you have PMR, take any medicines exactly as prescribed. As soon as you feel better, you can do your normal activities. Try to do regular weight-bearing activities, such as walking or weight lifting. Also, try to eat a healthy diet. You could ask your doctor how much calcium you need.

Experts don't fully understand what causes PMR. It may be that the immune system is attacking the body's own tissues. Your genes may play a role in this. For example, people whose ancestors came from Scandinavia or Northern Europe are more likely to have this problem.

PMR occurs in women more often than in men. It is more common as people get older.

Polymyalgia rheumatica (say "pah-lee-my-AL-juh roo-MAT-ih-kuh"), or PMR, is a condition that causes inflammation of the joints. This causes pain and stiffness, most often in the neck, shoulders, or hips.

Some people who have PMR also have giant cell arteritis. This is another inflammatory condition that affects the arteries that carry blood to the head. Giant cell arteritis is more dangerous than PMR, though. It can cause loss of vision, a stroke, or mini-strokes. The same medicines are used to treat PMR and giant cell arteritis.