Polymyalgia rheumatica
Definition
Polymyalgia rheumatica (PMR) is an inflammatory disorder involving pain and stiffness in the shoulder and usually also the hip.
Causes, incidence, and risk factors
Polymyalgia rheumatica is a disorder that almost always occurs in people over 50 years old. The cause is unknown.
PMR may occur alone, or with or before giant cell arteritis (also called temporal arteritis), which is inflammation of blood vessels (usually in the head).
References
Unwin B, Williams CM, Gilliland W. Polymyalgia Rheumatica and Giant Cell Arteritis.
Am Fam Physician; 2006; 74(9):1547-1554.
Review Date: 2/3/2011
Reviewed By: Michael E. Makover, MD, professor attending in Rheumatology at the New York University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Symptoms
The most typical symptom is pain and stiffness in both shoulders and the neck. This pain usually progresses to the hips, and there isfatigue too. It becomes more and more difficult for patients to get around.
Other symptoms include:
There are no specific joint symptoms.
Some people with PMR also have giant cell arteritis. This far more serious disease can cause:
Signs and tests
Lab tests cannot diagnose polymyalgia rheumatica. However, most patients with this condition have an elevated sedimentation rate (ESR), a blood test that can show certain kinds of inflammation.
Other test results for this condition (as well as for giant cell arteritis) include:
These tests may also be used to monitor patients' progress.
References
Unwin B, Williams CM, Gilliland W. Polymyalgia Rheumatica and Giant Cell Arteritis.
Am Fam Physician; 2006; 74(9):1547-1554.
Review Date: 2/3/2011
Reviewed By: Michael E. Makover, MD, professor attending in Rheumatology at the New York University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Treatment
Although there is no cure for polymyalgia rheumatica, treatment can help prevent patients from becoming disabled.
Low doses of corticosteroids (such as prednisone) can relieve polymyalgia rheumatica within a day or two. The dose can then be slowly reduced to a very low level, but the treatment will need to continue for a long time -- around 2 - 6 years.
Corticosteroids cause a variety of side effects that must be carefully monitored and managed.
Expectations (prognosis)
Polymyalgia rheumatica usually goes away by itself after 2 - 6 years. After this time, treatment can be stopped.
Complications
Polymyalgia rheumatica can cause serious disabilities if untreated.
Calling your health care provider
Call for an appointment with your health care provider if you have persistent weakness or stiffness of the shoulder and neck area, especially if you also have symptoms of general illness, such as fever or headache.
References
Unwin B, Williams CM, Gilliland W. Polymyalgia Rheumatica and Giant Cell Arteritis.
Am Fam Physician; 2006; 74(9):1547-1554.
Review Date: 2/3/2011
Reviewed By: Michael E. Makover, MD, professor attending in Rheumatology at the New York University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Prevention
There is no known prevention.
References
Unwin B, Williams CM, Gilliland W. Polymyalgia Rheumatica and Giant Cell Arteritis.
Am Fam Physician; 2006; 74(9):1547-1554.
Review Date: 2/3/2011
Reviewed By: Michael E. Makover, MD, professor attending in Rheumatology at the New York University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 2/3/2011
Reviewed By: Michael E. Makover, MD, professor attending in Rheumatology at the New York University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.