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Polymyalgia Rheumatica (PMR)

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Polymyalgia Rheumatica (PMR) is an inflammatory condition that many people now believe is a form of vasculitis. It causes pain, tenderness and stiffness in the large muscles around the shoulders, hips and back. It generally affects older people and is rare in people under 50. Each year about 4 out of every 10,000 people in the UK develop PMR, and about three quarters of these are women.

What are the Symptoms?

Symptoms often appear very suddenly, over just a few days, or may develop more slowly. It is easily confused with other conditions, and sometimes passed off as ‘the aches and pains of getting older’. However, people with PMR know the misery of constant discomfort and the fear and anxiety of suddenly not being able to move and get around.

• Stiffness, pain, aching, and tenderness in the muscles around the shoulders, pelvis, and neck
  
  
• Worse first thing in the morning but easing during the day
  
  
• Difficulty getting out of bed, reaching and rising
  
  
• Inflammation and swelling in other areas, e.g. tendons, hands, feet, and joints
  
  
• Tiredness
  
  
• Depression
  
  
• Night Sweats
  
  
• Fever
  
  
• Loss of Appetite
  
  
• Weight Loss

Symptoms typically develop over a few days or weeks, but in some cases can develop more slowly, and are often passed off as 'aches and pains of getting older'.

How is it diagnosed?

PMR is a bit mysterious. It ‘mimics’ other illnesses and in diagnosis other possibilities have to be ruled out first. A GP will take blood tests to test the ‘inflammatory markers’ in the body. The key tests are ‘ESR’ and ‘CRP’.

What is the Treatment?

Once diagnosed, treatment is with steroids (usually prednisolone) and recovery can be spectacular. The recommended starting dose is 15mg daily, tapering off to a ‘maintenance dose’ of 5-7mg a day. It often takes several months to get down to this. As soon as possible, the doctor will start reducing the dosage to reduce it to zero. In some cases, PMR ‘burns itself out’ after a couple of years. For other people, this can take longer. While reducing steroid use, painkillers such as paracetemol can be helpful. It’s important to remember that everybody is different, and our experiences of PMR and treatment can differ from the ‘textbook’ version.

Are there any Complications?

About 1 in 20 people on treatment for PMR (or 7 out of 20 people with untreated PMR) develop giant cell (or temporal) arteritis, a related condition causing inflammation of arteries (see section on Giant Cell Arteritis).

Consult a doctor urgently if you have PMR and you develop any of the following symptoms:

• Headache or tenderness on one side of your head.
  
  
• Jaw pain when chewing.
  
  
• Sudden loss of vision.
  
  
• Any other sudden visual problem in one eye.
  
  
• Weakness, numbness, deafness.

 

Resources

Polymyalgia Rheumatica - booklet Arthritis Research UK is a charity that funds high class research as well as educate and inform the general public about different musculoskeletal conditions. They released a booklet on Polymyalgia Rheumatica (PMR) which provides answers to questions about this condition. To read the booklet online, order a free copy or find out more information please visit the Arthritis Research UK website.