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Polymyalgia rheumatica

Definition:

Polymyalgia rheumatica (PMR) is an inflammatory disorder. It involves pain and stiffness in the shoulder and often the hip.



Causes, incidence, and risk factors:

Polymyalgia rheumatica most often occurs in people over 50 years old. The cause is unknown.

PMR may occur before or with giant cell arteritis (also called temporal arteritis ), in which blood vesseks that supply blood to the head become inflamed.



Symptoms:

The most common symptom is pain and stiffness in both shoulders and the neck. This pain usually progresses to the hips. Fatigue is also present. People with this condition find it increasingly hard to move around.

Other symptoms include:




Signs and tests:

Lab tests alone cannot diagnose polymyalgia rheumatica. Most patients with this condition have a high sedimentation rate (ESR ).

Other test results for this condition include:

  • Abnormal proteins in the blood
  • Abnormal white blood cells
  • Anemia (low blood count)

These tests may also be used to monitor your condition.



Treatment:

There is no cure for polymyalgia rheumatica. Low doses of corticosteroids (such as prednisone) can ease symptoms within a day or two. The dose can then be slowly reduced to a very low level, but treatment needs to continue for about 2 - 6 years.

Corticosteroids can cause many side effects so you need to be watched closely if you are taking these medicines.



Support Groups:



Expectations (prognosis):

Polymyalgia rheumatica usually goes away by itself after 2 - 6 years. You can stop taking medicines after this point.

More severe symptoms can make it harder for you to work or take care of yourself at home.

Complications:




Calling your health care provider:

Call your health care provider if you have weakness or stiffness in your shoulder and neck that does not go away, and you also have symptoms such as fever and headache.



Prevention:

There is no known prevention.



References:

Hellmann DB. Giant Cell Arteritis, Polymyalgia Rheumatica, and Takayasu’s Arteritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap 88.




Review Date: 2/21/2013
Reviewed By: Ariel D. Teitel, MD, MBA, Clinical Associate Professor of Medicine, NYU Langone Medical Center. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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