Polymyalgia Rheumatica (PMR)

Polymyalgia Rheumatica

What are polymyalgia rheumatica and giant cell arteritis? — Polymyalgia rheumatica is a condition that can cause stiffness and aching in the shoulders, neck, and hips. Sometimes it also causes swelling in joints such as the knees, hands, and feet. It usually occurs in people age 50 and older.
Giant cell arteritis is a condition that can cause headaches, trouble seeing, and jaw or arm pain. This condition affects blood vessels, usually in the head and sometimes in the neck. Blood vessels in the brain are not affected. Giant cell arteritis is sometimes called "temporal arteritis" because it often affects a blood vessel in the temple on the side of the head.
Polymyalgia rheumatica and giant cell arteritis are two different conditions. But they sometimes occur together. Usually, these conditions last between 1 and 3 years.
What are the symptoms of polymyalgia rheumatica and giant cell arteritis? — The most common symptoms of polymyalgia rheumatica are:
Pain and stiffness in the shoulders, hips, neck, or upper part of the body that is usually worse in the morning – These symptoms occur on both sides of the body and last 30 minutes or longer after getting up.
Swelling and stiffness in the knees, hands, wrists, ankles, or feet
Feeling tired
Weight loss
Fever
The most common symptoms of giant cell arteritis are:
Headaches – The pain is often over the temples (sides of the forehead) but can also be in the front or back of the head. Some people also have pain in the scalp when it is touched.
Pain in the jaw, especially after chewing or talking
Pain or weakness in the arm, especially when you move your arm
Trouble seeing clearly, or trouble seeing out of 1 eye
Cough (that is new) or sore throat
Other symptoms of giant cell arteritis can include:
Fever
Feeling tired
Weight loss
Are there tests for polymyalgia rheumatica and giant cell arteritis? — Yes. If your doctor or nurse suspects that you have polymyalgia rheumatica or giant cell arteritis, he or she will do an exam and order blood tests. He or she might also order an X-ray, MRI, or other imaging test. Imaging tests create pictures of the inside of your body.
To check for giant cell arteritis, your doctor might order a test called a biopsy. During a biopsy, a doctor takes a small piece of a blood vessel from under your skin on the side of the head. He or she then looks at the tissue under a microscope.
How are polymyalgia rheumatica and giant cell arteritis treated? — Both polymyalgia rheumatica and giant cell arteritis are treated with medicines called steroids. (These are not the same as the steroids some athletes take illegally. These steroids reduce swelling and ease pain.) Many people feel better after taking their first dose. But most people need to take steroids for 1 to 2 years.
Steroids can have side effects, so your doctor will want to make sure you are on the lowest dose possible for the shortest amount of time possible.
Doctors might also prescribe other types of medicines for people with giant cell arteritis. For example, most people with giant cell arteritis also take a low dose of aspirin every day to prevent vision loss or a stroke.
What else can I do? — It is important to follow all of your doctor's instructions about treatment and follow-up. For example, if you have giant cell arteritis, your doctor might order a test called a chest X-ray every year to check the blood vessels in your chest.
It's also important to let your doctor know if you have side effects from the treatment or if you develop new symptoms.
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This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15532 Version 9.0
Release: 28.2.2 - C28.105
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