Polymyalgia rheumatica (PMR)

What is polymyalgia rheumatica?

Polymyalgia rheumatica is a condition that causes inflammation of muscles which can lead to pain and stiffness. This normally affects the muscles of the shoulders, hips and neck. PMR is believed to be an autoimmune disease, where your body can’t tell the difference between your own cells and foreign, harmful ones, resulting in the body attacking itself.

What are the symptoms of polymyalgia rheumatica?

The most frequently occurring symptoms are: 

• Pain or dull ache in the shoulder muscles (neck and hip muscles can also be affected)

• Stiffness in the affected muscles that’s worse in the morning or after rest

Some less common symptoms include:

• Severe fatigue

• Mild fever

• Loss of appetite

• Weight loss

• Depression.

How common is polymyalgia rheumatica?

Polymyalgia rheumatica affects around 1 in 1,200 people, with twice as many women being diagnosed than men. It’s age-related so the majority of those diagnosed are between 70 and 80, and it’s very rare in those younger than 50. It usually only affects people who are white.

What causes polymyalgia rheumatica?

Polymyalgia rheumatica is considered to be autoimmune, we do not know the exact cause, but it’s believed to be a balance of genetic and environmental factors.

Some gene mutations have been linked to an increased chance of developing PMR, with certain genes named PMR genes. Some of the environmental factors that can trigger or worsen PMR are stress and UV exposure.

How is polymyalgia rheumatica diagnosed?

There’s no exact test for PMR but there are a few strategies that can be used to diagnose it. At first you may have blood tests which can check whether inflammation is present.  

It can also be diagnosed by ruling out similar conditions that can mimic PMR such as rheumatoid arthritis, tendonitis, lupus and fibromyalgia.

A medical professional will also look at your family history to look for any mutations that could cause the condition.

How is polymyalgia rheumatica treated?

The main treatment for PMR symptoms is corticosteroids such as prednisolone, which should give you some relief after 2 or 3 days. This is generally recommended for a long period of time to resolve your symptoms. It’s important that you don’t stop taking steroids suddenly, and seek help from your healthcare provider.

When should I seek help?

If you have pain or stiffness that lasts over a week, speak to a GP. Call 111 if you have been diagnosed with polymyalgia rheumatica and have:

• A severe headache

• Jaw pain that worsens when eating

• Tongue pain when chewing

• Vision loss.