Polymyalgia rheumatica 

Introduction 

A stiff or painful neck can be a sign of polymyalgia rheumatica 

Giant cell arteritis

Around one in five people with polymyalgia rheumatica develop a more serious condition called giant cell arteritis (also known as temporal arteritis), which can cause inflammation in the arteries of the head or neck, resulting in symptoms such as:

  • persistent severe headaches with scalp tenderness (the scalp is sore to touch)
  • pain in the jaw muscles when chewing
  • impaired vision, such as double vision or loss of vision

You should contact your GP immediately if you notice these symptoms.

Unlike polymyalgia rheumatica, giant cell arteritis is regarded as a medical emergency and without prompt treatment it can cause permanent visual impairment.

The symptoms of giant cell arteritis can develop before, after or at the same time as the symptoms of polymyalgia rheumatica.

Read more about giant cell arteritis.

Polymyalgia rheumatica (PMR) is a condition that causes pain, stiffness and inflammation in the muscles around the shoulders, neck and hips.

Polymyalgia rheumatica may also cause other symptoms, including:

  • a high temperature (fever)
  • extreme tiredness (fatigue)
  • loss of appetite
  • weight loss
  • depression

If you have pain and stiffness that lasts longer than a week, you should see your GP so the cause can be investigated.

It can be difficult to diagnose polymyalgia rheumatica because it has symptoms similar to many other conditions, such as rheumatoid arthritis. These conditions will need to be ruled out before polymyalgia rheumatica is diagnosed.

Read more about the symptoms of polymyalgia rheumatica and diagnosing polymyalgia rheumatica.

How is it treated?

The main treatment for the condition is a steroid medication (corticosteroids) called prednisolone, which is used to help relieve your symptoms.

You will initially be prescribed a high dose of prednisolone, which will be reduced gradually over time.

Most people with polymyalgia rheumatica will need to take a long-term course of corticosteroid treatment (lasting one to two years) to prevent their symptoms returning.

Read more about treating polymyalgia rheumatica.

Who is affected?

Polymyalgia rheumatica is relatively common in the UK. It is estimated that one in every 1,200 people develop the condition every year.

Polymyalgia rheumatica is an age-related condition. Most people diagnosed with the condition are over 70 years old and cases affecting people younger than 50 are almost unheard of.

The condition is two to three times more common in women than men. It is more widespread among white people, particularly those of northern European descent.

The cause of polymyalgia rheumatica is unclear. However, it is thought that a combination of genetic and environmental factors is responsible.

Page last reviewed: 28/01/2013

Next review due: 28/01/2015

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Comments

The 12 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Mysayso said on 30 March 2014

My PPMR has been treated since July 20123 with Prednisalone injections approximately every 12 weeks. Yesterday I was boasting that it had burnt itself out as I had no symptoms. Ho! Ho! I woke up this morning with swollen hands also painful and stiff and very cranky knees. So back to the rheumatologist again I fear.

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Sub80 said on 27 March 2014

My friend has been diagnosed with this condition,3 months after starting to take statins,is there a connection?

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CJMorny said on 18 September 2013

I have been told that it is likely that I have Fibromyalgia but the fever and pain in the hips that I get in addition to other pain makes me think it is more likely to be polymialgia. This would be a relief as at least there seems to be treatment for it.

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User163496 said on 30 July 2013

Ive just been diagnosed with Pmr after being in constant pain for a few years. I do work but first thing in a morning i really do struggle to get out of bed and get started. Somedays its so bad i dont want to go in and feel like quitting but i push myself and go. the doctor has prescribed me an anti inflam which having read the posts seems unusual, im trying to loose weight so maybe thats why. Its good to finally know whats wrong with me after all this time.

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triciam said on 18 June 2012

I was diagnosed with PMR in November 2011 and have been on various doses of Prednisalone since then. The lower the dose the worse the pain. I recently had to have a routine eye test and have been referred to local eye clinic as optician thought retinal dterioration was related to PMR. My biggest worry is the effect the predinisalone is having on my bones. In 2010 I had to have a hip replacement, originally from 1979, re-done as the old prosethis had worked its way through the femur leaving a hole. Consequently I now have a long stem prosthesis which reaches almost to my knee. The bone graft done at the time didn't work too well and bone growth has been minimal. I take a weekly Alendronic Acid tablet to slow down bone deterioration from the steroids but I'm sure that I'm risking damage to the femur and hip joint with continued use of steroids. Another problem is that strong pain killers cause violent vomitting so I'm limited to paracetamol and ibuprofen.

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spyvee24 said on 08 March 2012

my husband had problemswith severe pains and after many times of visiting gp he was started on prednisolone with amazing results within 48hrs, he became a new man. the gp reduced the dose over a couple of months, the lower the dose the pains started to return but no where near what they were to start with, but the gp has stopped the prednisalone and is referring him to a rheumatologist and now my husband feels he has been left to be in pain and it is worsening by the day, we are worried that it is going to return to the severity it was when he could sometimes not even turn over in bed. he cannot afford to start turning work down again. it is very distressing to see him like this and we do not know whetrher he is just going to have to live with it. it does not seem right to be laeft like this

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dorron said on 14 February 2011

i have so iam to believe pmr/osteo my treatment for the past 4years,is prednisolone and at present methotresate 10x2,5mg together over the years the steroid has affected my eyesight.at present my dose of this steroid is 2mg.in the past few weeks i have tried to reduce this steroid to 2 and 1 on alternative days,within 1 week all the problems returned,ie shoulders,swollen hands,cannot grip anything,and to top it all both my knees have got worse.proving that taking methetresate ahs no affect at all.has anybody else had these problems

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havfruen said on 29 October 2010

I was diagnosed with PMR in September 2001 and suffered really badly for 6 years even though prednisolone helped a great deal. I was eventually weaned off the prednisolone and managed on prescribed painkillers and anti-inflammatory tablets for a while. They however gave me a bad stomach so I eventually had to come off them. This has unfortunately resulted in another flare up of the PMR and I am now suffering worse than before. I really do not want to go back on the Prednisolone. Any other suggestions?

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Alfreda70 said on 07 June 2010

I have had PMR for 4 years and am currently on a low dose of prednisalone. I have experienced dramatic reduction in pain and stiffness after eating pineapples. I have tried to navigate my way through the internet but find so much information it is difficult to understand. Has any research been done into the effects of bromelain on PMR?

I have CKD level 3 and have read that one should not take bromelain in this situation and also that it should not be taken for more than 2 weeks. has anyone any information on this, please?

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Tomargan said on 18 April 2010

i have had this gca and pmr for the last year it is very a debhlitating, nasty thing to have got. my life has changed a lot, so much pain, i was taking steroids but am off them at present, as they allowed too much fluid to collect in my legs and now they are inflammed, i take morphine for the pain i am having. there seems nbo end to it all.

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pat16 said on 10 February 2010

I have suffered from chronic Fibromyalgia for about 12 years now. I take over 20 tablets per day most of which are pain killers. From time to time I have had bad relapsed which leave me vertually helpless for a few days and then I pick up a little and can do light tasks working at my own pace. Lately the pain as been getting worse and I have just been diagnosed with PMR. Apparently the only way to be sure is to have an ESR blood test as this is the only thing that shows it up.

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maxamillion said on 18 June 2009

one question regarding PMR and GCA. I have been diagnosed with PMR, my Doctor gave me tablets for my shoulder pain. He told me to watch out for any signs of vision problems and to contact him. Now that i have read the above info on PMR, i have discovered that GCA is related to PMR with the possible vision problem that may occur as stated. I am a bit concerned about this and how can i be sure that i do have PMR? Are these steroid tablets that neccessary for me to take if i don't have GCA.

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