Overview

Polymyalgia rheumatica is a rheumatic disorder associated with pain and stiffness in the neck, shoulder, and hip area. Stiffness is most noticeable in the morning or after resting. You may also have a fever, weakness, and weight loss. This disorder may develop rapidly; in some people it comes on literally overnight. But for most people, it develops more gradually.

People with polymyalgia rheumatica often have giant cell arteritis, a disorder associated with inflammation of arteries located on each side of the head.

Who Gets

Women are more likely than men to develop polymyalgia rheumatica. This disease mostly affects people over the age of 50, with highest rates at 70 to 80 years of age.

Symptoms

Symptoms of polymyalgia rheumatica can include:

  • Pain and stiffness in the neck, shoulder, and hip area.
  • Flu-like symptoms, including fever, weakness, and weight loss.

Causes

Researchers don’t know what causes polymyalgia rheumatica. It is associated with:

  • Immune system problems.
  • Genes.
  • Environmental triggers, such as an infection.
  • Aging processes.

Diagnosis

There is no single test for polymyalgia rheumatica. To diagnose you with the disease, your doctor may:

  • Ask you about your medical history.
  • Give you a physical examination.
  • Take blood to run different tests that measure:
    • Erythrocyte sedimentation rate (sed rate): a test that measures inflammation by seeing how quickly red blood cells fall to the bottom of a test tube of unclotted blood.
    • C-reactive protein levels.
    • Rheumatoid factor protein levels to rule out rheumatoid arthritis.

Treatment

Polymyalgia rheumatica is treated by medications including:

  • Corticosteroids such as prednisone. You will start with a low daily dose that is increased as needed until symptoms disappear. Your doctor may then gradually reduce the dosage, and you will probably stop taking the medication after six months to two years. Your doctor will put you back on the corticosteroid if symptoms reappear with lower doses of the medication. You will stop taking the medicine when symptoms clear up completely.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. The medication must be taken daily, and long-term use may cause stomach irritation. For most patients, NSAIDs alone are not enough to relieve symptoms.

Even without treatment, polymyalgia rheumatica usually disappears within one to several years. With treatment, however, symptoms disappear quickly, usually in 24 to 48 hours. If corticosteroids don’t bring improvement, the doctor is likely to consider other possible diagnoses.

Research Progress

Research on polymyalgia rheumatica includes:

  • Causes and mechanisms. Researchers studying possible causes of polymyalgia rheumatica are investigating the roles of genetics and environment as well as immune system problems.
  • Disease prognosis. By examining people with and without the condition, doctors are starting to understand factors associated with disease symptoms and outcomes.
  • Treatment. Researchers are exploring treatments that might result in lower doses of oral steroids and control the disease with fewer drug side effects.
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