Polymyalgia rheumatica

What is polymyalgia rheumatica?

Polymyalgia rheumatica (PMR) is an inflammatory condition that causes muscle pain, mainly affecting the muscles of the shoulder and the thigh. PMR is rarely diagnosed under the age of 50 and is more commonly diagnosed in patients over 60 years of age. Women are affected about 2-3 times more than men, and the condition affects 1 in 2000 people.

The main symptoms of PMR are pain and stiffness in the shoulders and thighs, often worse in the morning. It can often come on quite suddenly, developing over one to two weeks. Other symptoms may include feeling generally unwell, having a fever, weight loss and tiredness.

It is important to note that PMR can be associated with another condition called giant cell arteritis (GCA) – about 20% of people with PMR will develop GCA.

How is polymyalgia rheumatica treated?

Although standard painkillers and anti-inflammatories (NSAIDs) might be useful, they are not normally sufficient on their own. PMR usually responds well to a course of steroids such as prednisolone. Once started, the symptoms are often relieved very quickly. Over time, your doctor will start to reduce the dose of steroid gradually (it is important not to stop steroids suddenly). Your doctor may be guided by blood tests to measure your body’s inflammatory response whilst the dose is being reduced. Sometimes you may have a relapse of the condition, resulting in the dose being increased again.

If your symptoms don’t respond to steroids, you may be prescribed a medication belonging to a group of drugs called disease modifying anti-rheumatic drugs (DMARDs), for example, methotrexate or leflunomide. These drugs reduce the activity of your body’s immune system, resulting in reduced inflammation.

Where can I find out more about polymyalgia rheumatica?

Versus Arthritis  provides further information on diagnosis, treatment options and living with PMR

Last updated: February 6, 2020