Polymyalgia Rheumatica

What is Polymyalgia Rheumatica?

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Polymyalgia Rheumatica is a very common condition and one that I see a lot of as a Rheumatologist.

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It is a condition of immune inflammation in the body, where people get a lot of pain and stiffness around their shoulders and their hips.

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What are the symptoms of Polymyalgia Rheumatica?

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Polymyalgia Rheumatica causes a person to have a lot of pain and stiffness around their shoulders and hips. Typically these symptoms are very bad in bed, with people even finding it hard to turn over in bed!

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It can also sometimes be associated with swelling of the hands, and it can cause a person to be feel very tired and generally unwell. Symptoms are generally worse with inactivity and get better with movement.

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Who gets Polymyalgia Rheumatica?

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PMR affects people over the age of 50, usually over the age of 60. The most common age group is between 70-80.

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Women are affected at least 2-3 times more than men.

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What causes Polymyalgia Rheumatica?

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We don't know what causes Polymyalgia Rheumatica. There is a strong association with a condition called Giant Cell Arteritis with between 5-30% of people with Polymyalgia Rheumatica getting Giant Cell Artertitis.

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How is Polymyalgia Rheumatica treated?

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Prednisolone is the mainstay therapy for Polymyalgia Rheumatica. 

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Your Rheumatologist will tailor the doses of Prednisolone needed to control your disease.

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Usual starting doses range from 20-15mg, and are gradually weaned down over the course of 6 months to a year depending on how your disease responds to treatment.

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How is Polymyalgia Rheumatica diagnosed?

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The diagnosis of Polymyalgia Rheumatica is made on the basis of typical symptoms and the presence of elevated markers of inflammation in the blood, ESR and/or CRP.

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Your Rheumatologist may investigate you to rule out other causes of your symptoms and these investigations will be tailored according to your specific set of symptoms. Everyone has a unique presentation with illness and needs to be investigated and treated accordingly.

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What is the long term outcome with Polymyalgia Rheumatica?

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Usually the disease resolves within 1-2 years. In these cases the Prednisolone can be ceased.

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In a small number of people the symptoms are persistent and people cannot come off the Prednisolone completely. Some people may need to be on long term low doses of Prednisolone to keep the symptoms controlled.