Polymyalgia rheumatica (PMR) is a condition where you develop pain in your neck, and around your shoulders and hips. “Myalgia” comes from the Greek word for “muscle pain,” and the term “poly” means more than two. The pain and stiffness can be very severe, and affect what you are able to do in everyday life. It is worse in the morning. PMR is most common in people over 50. Unlike other aches and pains older people get, no-one knows what causes this condition.
Who is at risk?
PMR occurs only in older adults and very rarely in people younger than 50. The average age of onset of symptoms is 70, so people who have PMR may be in their 80s or even older. Older women are at least two to three times as likely to get PMR as older men. It is also much more common in people of white, European origin.
Signs and Symptoms
PMR usually comes on suddenly, appearing over a week or two, sometimes just after a flu-like illness. You may go to bed feeling fine, but wake up feeling stiff in the morning. However, in some people, the symptoms come on over a longer period of time and can take longer to go away.
With PMR, you could experience:
- Stiffness and severe pain in the morning, which may get better during the day
- You may find it hard to turn over in bed, get out of bed, or to dress yourself pain in your hips, thighs or back pain in your neck and shoulder muscles, which lessens when you move
- Stiffness after sitting for any length of time
- Feeling generally unwell, and possibly getting a slight temperature
- Tiredness and depression
- Swelling of the hands and wrists (rarely)
In PMR, results of blood tests to detect inflammation are usually abnormally high. One such test is the erythrocyte sedimentation rate (ESR). Another is the C‐reactive protein, or CRP. Both of these tests are typically significantly elevated in PMR.
Most people’s symptoms disappear after a time often two to two and a half years. But treatment may last for two or more years, and some people may need to remain on a small dose of medication for many years.
Corticosteroids: The pain of PMR can be greatly reduced by taking a drug called a corticosteroid. Corticosteroids reduce inflammation in our bodies. The most common type of corticosteroid given by doctors for PMR is called prednisolone. It comes as a tablet or injection. However, corticosteroids can have many side effects as well. The longer you take corticosteroids or the higher the dose, the more likely you are to get side effects.