Polymyalgia Rheumatica (PMR) causes widespread pain, stiffness, and fatigue, especially in the neck, shoulders, hips, and thighs, often worse in the mornings or after rest, making daily activities hard. General symptoms include mild fever, weight loss, and tiredness, while immediate medical attention is crucial for headache, jaw pain, or vision changes, which could signal serious giant cell arteritis (GCA).
The most common symptom of polymyalgia rheumatica (PMR) is pain and stiffness in the shoulders, neck and hips, which develops quickly over a few days or weeks. Both sides of the body are usually affected. The stiffness is often worse first thing in the morning after you wake up.
5 Diseases That Can Mimic Polymyalgia Rheumatica
Some patients with PMR also have giant cell arteritis, a more serious condition that can result in heart attack, stroke or sudden blindness. Its symptoms include headache, pain and tenderness of the temples, visual problems, dizziness and balance issues.
Tests. There's no specific test for polymyalgia rheumatica, but it's likely that a series of blood tests will be done. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are blood tests that can be used to check the levels of inflammation in your body.
The exact cause of polymyalgia rheumatica (PMR) is unknown, but it's believed to stem from a mix of genetic predisposition and environmental triggers, potentially involving an autoimmune response where the immune system mistakenly attacks healthy tissues, causing inflammation in the shoulders, hips, and neck, especially in older adults. Infections, hormonal changes, and certain genetic factors are being studied as potential triggers for this inflammation.
By measuring the levels of c-reactive protein in your blood, a CRP test can tell your health care provider how much inflammation you have in your body. High CRP levels may mean you have an acute or chronic health condition, such as: Infections from bacteria or viruses.
People with polymyalgia rheumatica sometimes have another disorder called giant cell arteritis, which is associated with inflammation of arteries, especially those located on each side of the head, scalp, and the aorta (the large artery that carries blood from the heart) and its main branches.
Parsonage-Turner syndrome causes sudden, intense pain in your shoulder and upper arm followed by muscle weakness. It can last for several days, weeks or months, and affects each person differently. Healthcare providers can offer many treatment options to help manage pain and muscle weakness.
The symptoms of polymyalgia rheumatica most often affect both sides of the body. They might include: Aches or pain in the shoulders. Aches or pain in the neck, upper arms, buttocks, hips or thighs.
Further, non musculoskeletal conditions such as, infectious causes (viral illness, endocarditis, tuberculosis), endocrine causes (eg hypothyroidism), malignancy (myeloma, carcinoma and lymphoma) can also mimic PMR. Thus PMR is a diagnosis of exclusion.
Does polymyalgia rheumatica affect the heart? Yes, polymyalgia rheumatica can increase a person's likelihood of having a heart attack. According to studies, patients with polymyalgia rheumatica have a heart attack risk 2.5 times higher than those without the condition.
Imaging tests.
An ultrasound can tell whether you have inflammation of the joints and soft tissues and can help in the diagnosis of polymyalgia rheumatica. Some people have an MRI or a PET scan to look for other causes of joint pain.
Silent vasculitis may accompany polymyalgia rheumatica (PMR), resulting in complications such as vision deterioration. Reduced visual field is a possible manifestation.
Patients experiencing chronic fatigue related to autoimmune conditions often describe their symptoms as more than just feeling tired during the day. This is significant exhaustion that impacts quality of life and makes it difficult to function on a normal basis.
Symptoms specifically related to the inflamed arteries of the head include:
One of the primary red flags for shoulder pain is the severity and persistence of the discomfort. If the pain is intense, unrelenting, or worsening over time despite rest and over-the-counter pain medications, it may indicate a significant underlying issue such as a fracture, dislocation, or severe soft tissue injury.
The main symptom is muscle stiffness in the morning that lasts longer than 45 minutes. Other symptoms may include: extreme tiredness. loss of appetite.
Upper back pain between the shoulder blades may result from poor posture or muscle strain. However, it can also stem from more serious problems with the spine, such as scoliosis or osteoarthritis. Treatments for mild upper back pain include stretching exercises and pain relievers.
Fatigue, depression, night sweats, loss of appetite, weight loss, and low-grade fever may also occur in patients with PMR. Polymyalgia rheumatica affects more than 200 000 people in the US aged 50 years or older and occurs more commonly in women.
The main symptoms are:
Other medicines
It may help people with polymyalgia rheumatica who have frequent relapses or do not respond to normal steroid treatment. Your doctor may recommend painkillers, such as paracetamol to help relieve your pain and stiffness while your dose of prednisolone is reduced.
Clinically, acute inflammation is characterized by five cardinal signs: rubor (redness), calor (heat), tumor (swelling), dolor (pain), and functio laesa (loss of function).
To reduce body inflammation and support natural detoxification, focus on an anti-inflammatory diet rich in fruits, vegetables, fatty fish, and whole grains, while limiting processed foods, sugar, and refined oils; incorporate fiber for gut health, stay hydrated with tea and water, manage stress, get adequate sleep, and consider exercise and supplements like omega-3s or turmeric, say experts from Cleveland Clinic, Healthline, Johns Hopkins Medicine, and Harvard Health.
A gallium scan is a test to look for swelling (inflammation), infection, or cancer in the body. It uses a radioactive material called gallium and is a type of nuclear medicine exam. A related test is a gallium scan of the lung .