Polymyalgia Rheumatica (PMR)

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

Polymyalgia Rheumatica (PMR) Complication

Temporal Arteritis (Giant Cell Arteritis)

Giant cell arteritis, also called temporal arteritis or cranial arteritis, is a serious disease characterized by inflammation of the walls of the blood vessels (vasculitis). The vessels affected are the arteries (hence the name "arteritis"). Giant cell arteritis occurs in 10%-15% of patients with polymyalgia rheumatica. The age of affected patients is over 50 years of age, identical to that of polymyalgia rheumatica.

Polymyalgia rheumatica (PMR) facts

  • Polymyalgia rheumatica (PMR) is a disease that causes pain and stiffness in muscles and joints.
  • PMR is diagnosed by characteristic symptoms associated with abnormal blood testing for inflammation.
  • Treatment of the disease involves taking low doses of cortisone medications.

What is polymyalgia rheumatica?

Polymyalgia rheumatica is a disease of the muscles and joints characterized by muscle pain and stiffness, affecting both sides of the body, and involving the shoulders, arms, neck, and buttock areas. People with the disease are typically over 50 years of age. Polymyalgia rheumatica is abbreviated PMR.

PMR and temporal arteritis (giant cell arteritis) sometimes occur in the same patient. About 10%-15% of people with PMR also have giant cell arteritis.

What are polymyalgia rheumatica causes and risk factors?

The cause of the condition is not known. Recent research has indicated that genetic (inherited) risk factors play a role in who becomes afflicted with the illness. Theories have included viral stimulation of the immune system in genetically susceptible individuals. Rarely, the disease is associated with a cancer. In this setting, the cancer may be initiating an inflammatory immune response to cause the polymyalgia rheumatica symptoms.

What are symptoms and signs of polymyalgia rheumatica?

The onset of the disease can be sudden. A patient may have a healthy history until awakening one morning with stiffness and pain of muscles and joints throughout the body. These pains can lead to a sensation of weakness and loss of function. Sometimes there is also muscle tenderness with PMR. These symptoms persist and often include an intense sensation of fatigue. Some patients notice a gradual loss of appetite accompanied by weight loss and lack of energy. Depression can occur.

How do health care professionals make a diagnosis of polymyalgia rheumatica?

The diagnosis of the disorder is suggested by the health history and physical examination. The doctor frequently notes muscle tenderness and that the motion of the shoulders is limited by pain. The joints are usually not swollen. However, swelling of the small joints of the hands, wrists, and/or knees can occur. Blood testing for inflammation is generally abnormal, as indicated by a significant elevation in the erythrocyte sedimentation rate (sed rate or ESR) and/or C-reactive protein. There are no specific tests, however, for the condition and X-rays are normal. The diagnosis is based on the characteristic history of persisting muscle and joint pain and stiffness associated with elevated blood tests for inflammation, such as the ESR. It is also not unusual for patients to have slight elevations of liver blood tests.

Medically Reviewed by a Doctor on 3/16/2017

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