Polymyalgia rheumatica (PMR) is a rare inflammatory disease that causes muscle pain and stiffness. It is a disease of the elderly. It rarely affects anyone under the age of fifty. The highest prevalence is between the ages of seventy and eighty.
Initially, rheumatoid arthritis may be misdiagnosed as polymyalgia rheumatica.
The cause is unknown but there is a genetic link and since it affects those over fifty, it may be associated with the aging process. PMR affects more women and Caucasians of northern European descent.
It classically causes muscle pain and stiffness. It may include the neck, shoulders, upper arms, lower back, hips and thighs bilaterally. PMR does not usually include the lower arms, hands, lower legs and feet.
It frequently attacks the shoulder girdle first. One side first before the other joins in. It is more severe in the morning and after periods of inactivity. The pain and stiffness may make dressing difficult. Affected thighs and buttocks make getting out of bed difficult. Shoulder involvement causes difficulty combing and brushing hair.
There are a variety of systemic symptoms including fatigue and a feeling of not being well. About thirty percent have rheumatoid arthritis like symptoms including joint pain, swelling and destruction.
PMR is not curable. It is manageable, however. Initial treatment may be NSAIDs like ibuprofen or aspirin. Next the drug of choice is a corticosteroid such as prednisone which helps to controls the symptoms. Prednisone is usually started around 25 mg daily for a month and then tapered to a dose that controls symptoms.
Of course, one of the problems with polymyalgia rheumatica is its association with giant cell arteritis. Fifteen to twenty percent of those with polymyalgia rheumatica also have giant cell arteritis which is an autoimmune disease causing inflammation in the lining of arteries particularly in the temporal arteries of the head. Symptoms include headaches, jaw pain, scalp discomfort and blurred vision. A person may have both conditions at the same time.