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Polymyalgia rheumatica is a rare inflammatory disease that causes muscle pain, stiffness, and generalized systemic symptoms such as fatigue, low-grade fever, and weight loss. It affects mainly older adults, typically those over 50, and is more common in women. While the exact cause is unknown, immunological factors and genetic predispositions may play a role. The condition is characterized by severe muscle aches, particularly in the neck, shoulders, and thighs, and can make daily activities challenging. In some cases, polymyalgia rheumatica can lead to muscle weakness and even permanent disability, although this is rare.
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What You'll Learn
Polymyalgia rheumatica causes muscle pain and stiffness
Polymyalgia rheumatica is a rare inflammatory disease that causes muscle pain and stiffness. It is characterised by severe muscle pain (myalgia), stiffness, and additional generalised systemic symptoms such as fatigue, fever, and weight loss. The condition primarily affects the shoulders, neck, hips, and thighs, with symptoms typically worsening in the morning and after periods of inactivity.
The exact cause of polymyalgia rheumatica is unknown, although immunological factors and genetic predispositions may play a role. It is more common in older adults, typically occurring between the ages of 50 and 80, and is more prevalent among those assigned female at birth and individuals of white race, especially those from Scandinavia or northern Europe.
The symptoms of polymyalgia rheumatica include moderate to severe muscle pain and stiffness, which can make daily activities challenging. The pain and stiffness are often widespread and can be debilitating, impacting mobility and causing difficulty with tasks such as dressing, reaching, washing, and climbing stairs. The stiffness associated with polymyalgia rheumatica can be severe enough to result in day-long immobilisation.
In addition to muscle pain and stiffness, polymyalgia rheumatica can also cause muscle weakness, although this is typically due to the stiffness and pain rather than actual muscle damage. The condition can also lead to giant cell arteritis, an inflammation of the arteries, which can cause headaches, jaw pain, vision problems, and scalp tenderness.
Treatment for polymyalgia rheumatica aims to relieve symptoms and gradually reduce medication doses to minimise side effects. Corticosteroids are commonly used, but long-term use can have adverse effects, so regular medical supervision is necessary. Pain-relieving medications, non-steroidal anti-inflammatory drugs (NSAIDs), and topical treatments can also provide temporary relief from pain and stiffness. Physiotherapy and weight-bearing exercises, such as walking, can help maintain mobility and bone strength.
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It can lead to giant cell arteritis
Polymyalgia rheumatica is a rare inflammatory disease that causes muscle pain, stiffness, and generalised systemic symptoms such as fatigue. It is most common in people over 50, and in those of Northern European ancestry. It is closely related to giant cell arteritis, another inflammatory disorder.
Giant cell arteritis is characterised by progressive inflammation of many arteries of the body. It can cause headaches, vision problems, jaw pain, and scalp tenderness. It may also lead to irreversible blindness if left untreated. About 10% of people with polymyalgia rheumatica have giant cell arteritis, and about 50% of those with giant cell arteritis have polymyalgia rheumatica. These two disorders have been described in medical literature as possible variants of the same disease process.
The exact cause of polymyalgia rheumatica is unknown, but immunological factors and familial tendencies (genetic predisposition) have been mentioned in the medical literature. Genes may also be a cause, as certain genes and gene changes might raise the risk of polymyalgia rheumatica. Polymyalgia rheumatica is more common in women, and it is more frequent in older adults, usually affecting those between 70 and 80 years of age.
The symptoms of polymyalgia rheumatica include muscle pain and stiffness, particularly in the neck, shoulders, upper arms, thighs, buttocks, and hips. These symptoms are usually worse in the morning or after a period of inactivity. Other symptoms include low-grade fever, weight loss, fatigue, loss of appetite, and a general feeling of ill health.
Giant cell arteritis, also known as temporal arteritis or Horton's disease, involves painful inflammation of the blood vessels (arteries) of the skull. It most commonly involves the temporal artery, but it can also affect other medium and large blood vessels, such as those going to the heart. Symptoms of giant cell arteritis include headaches, scalp tenderness, jaw pain, and eye problems. It can also cause weight loss and fever.
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The condition is more common in older adults
Polymyalgia rheumatica is a rare inflammatory disease that causes muscle pain, stiffness, and generalised systemic symptoms such as fatigue, low-grade fever, and a general feeling of ill health. It is a condition that primarily affects older adults, with most cases occurring between the ages of 70 and 80. People over the age of 50 are most commonly affected, and it becomes more common with increasing age. The condition is rare in those under 50.
The exact cause of polymyalgia rheumatica is unknown, but it is believed that immunological factors and genetic predisposition may play a role. It is more common among people assigned female at birth, with women being two to three times more likely to develop the condition than men. Additionally, it is most prevalent in white individuals, especially those of Scandinavian or northern European descent.
The symptoms of polymyalgia rheumatica typically include severe muscle aches and stiffness, particularly in the neck, shoulders, hips, and thighs. The pain and stiffness can be so severe that daily activities such as getting dressed, combing hair, or even getting out of bed become challenging. The condition can also cause weight loss, fatigue, and depression. While it can cause muscle pain, polymyalgia rheumatica does not typically lead to muscle weakness or atrophy. However, in rare cases, permanent muscle weakness and degeneration can occur.
The treatment for polymyalgia rheumatica aims to relieve symptoms and gradually reduce medication doses to minimise side effects. Corticosteroids are commonly used, but they can cause side effects in older adults, so regular medical supervision is necessary. Non-steroidal anti-inflammatory drugs (NSAIDs) and pain-relieving medications can also provide temporary relief. Physiotherapy and weight-bearing exercises, such as walking, can help maintain mobility and bone strength.
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It is characterised by severe musculoskeletal symptoms
Polymyalgia rheumatica (PMR) is a rare inflammatory disease that causes severe muscle pain (myalgia) and stiffness, particularly in the neck, shoulders, thighs and hips. It is characterised by severe musculoskeletal symptoms, including pain and stiffness in the muscles, which can make it difficult for patients to perform basic tasks such as getting out of bed, standing up from a chair, combing their hair, praying, or even getting dressed.
The condition usually affects people over the age of 50, with the risk increasing with age, and is more common in women than in men. PMR is also more prevalent among white people of Scandinavian or northern European descent. The exact cause of PMR is unknown, but it is believed that immunological factors, genetic predisposition, and certain genes and gene changes may play a role.
In addition to the musculoskeletal symptoms, people with PMR may experience a range of other symptoms, including fatigue, low-grade fever, weight loss, loss of appetite, a general feeling of ill health (malaise), and depression. In some cases, PMR may also be associated with giant cell arteritis (GCA), an inflammatory disorder affecting the arteries, particularly in the head, causing symptoms such as headaches, jaw pain, and scalp tenderness.
While PMR can cause severe musculoskeletal symptoms, it is important to note that it does not typically cause actual muscle weakness. However, the stiffness and pain associated with PMR can lead to limitations in range of motion and functional impairment, which may be considered a form of weakness. The severity of symptoms may vary, and in rare cases, permanent muscle weakness, degeneration, and loss of muscle mass (atrophy) can occur.
The diagnosis of PMR is based on a combination of clinical symptoms, blood tests, and imaging scans. Treatment aims to relieve symptoms and slowly reduce medication doses to prevent symptom recurrence. Corticosteroids are commonly used, but they may cause side effects, especially in older adults. Physiotherapy and weight-bearing exercises can also help manage pain and stiffness, improve mobility, and reduce the risk of osteoporosis.
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Treatment includes medication and lifestyle changes
Polymyalgia rheumatica is a rare inflammatory disease that causes muscle pain, stiffness, and generalised systemic symptoms such as fatigue, low-grade fever, and a feeling of ill health. While the exact cause of the disease is unknown, it is believed to be related to immunological factors and genetic predispositions. Treatment for polymyalgia rheumatica typically includes medication and lifestyle changes, which aim to keep patients symptom-free and prevent long-term health problems.
Medication
The main treatment for polymyalgia rheumatica is a type of steroid called a corticosteroid, specifically prednisolone. This medication is an anti-inflammatory drug that can reduce or eliminate stiffness and pain. Prednisolone is typically taken orally as a tablet and may be prescribed at a moderate dose, gradually reduced over time as symptoms improve. Most people take corticosteroids for 1 to 2 years or more, and many return to their previous level of activity. However, long-term use of corticosteroids can have serious side effects, including weight gain, bone thinning, high blood pressure, diabetes, and vision loss. It is important for patients to work closely with their healthcare team to monitor these side effects and adjust their dosage or take additional medicines to manage them.
Some patients may also be prescribed immunosuppressant medication, such as methotrexate, to suppress their immune system and reduce frequent relapses. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may also be recommended by healthcare professionals to ease symptoms. These can be purchased over the counter without a prescription. Additionally, the U.S. Food and Drug Administration has approved sarilumab (Kevzara) for people whose symptoms return. This medication is administered as a shot every two weeks and works by blocking substances that cause inflammation.
Lifestyle Changes
Polymyalgia rheumatica can cause significant fatigue, making rest an important part of managing the condition. Patients are also encouraged to use assistive devices, such as luggage and grocery carts or reaching aids, to make daily tasks easier. A healthy diet, focusing on fruits, vegetables, whole grains, and low-fat protein and dairy products, can help prevent fluid buildup and high blood pressure. Regular exercise, as recommended by a healthcare team, can help strengthen bones and muscles. Physical therapy may also be suggested to improve mobility and overall health.
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Frequently asked questions
Polymyalgia rheumatica (PMR) is a rare inflammatory disease that causes muscle pain and stiffness, mainly in the shoulders and hips. It is a relatively common condition that mainly affects people over 50, and becomes more common as people get older.
Symptoms of polymyalgia rheumatica include severe muscle aches and stiffness, pain, unexplained weight loss, fatigue, fever, loss of appetite, and depression. The symptoms are usually worse in the morning and can make it hard to do daily activities such as getting out of bed, standing up from a chair, or getting dressed.
Polymyalgia rheumatica is typically treated with corticosteroids, which help to relieve symptoms and reduce inflammation. Other treatments include pain-relieving medications (analgesics), non-steroidal anti-inflammatory drugs (NSAIDs), and lifestyle changes such as physiotherapy and exercise.
While polymyalgia rheumatica can cause muscle pain and stiffness, it does not typically cause muscle weakness. However, in rare cases, it may lead to permanent muscle weakness, degeneration, and loss of muscle mass.
