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by Badash M

Polymyalgia Rheumatica

(PMR)

Definition

Polymyalgia rheumatica (PMR) is an inflammatory disorder. It results in muscle pain and stiffness in the body. The effects are most common in the shoulders, arms, hips, and thighs. About 15% of people with PMR will also develop giant cell arteritis (GCA). GCA is an inflammation of the lining of the arteries, the blood vessels that carry blood away from the heart.
Giant Cell Arteritis
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Causes

The exact cause is not known. Inflammatory conditions may be due to some problem with the immune system. Some evidence suggests that certain viruses could be responsible for PMR. Genetic factors may also play a role.

Risk Factors

PMR is most common in Caucasian women, aged 65 years and older.

Symptoms

Symptoms may include:
  • Muscle pain and/or stiffness in the hip, shoulder, or neck areas
  • Stiffness in the morning
  • Fever
  • Unexplained weight loss
  • Fatigue
  • Mood changes

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
Images may be taken of your bodily structures. This can be done with:

Treatment

Symptoms of PMR will disappear without treatment within several months to years. Treatment leads to dramatic improvement, which may occur within 24-48 hours.
Treatment may include:
  • Anti-inflammatory medications
  • Corticosteroids
  • Supplements, such as calcium or vitamin D
  • Physical therapy to help with strength, flexibility, and mobility

Prevention

There are current guidelines to prevent PMR.

RESOURCES

American College of Rheumatology
http://www.rheumatology.org
Arthritis Foundation
http://www.arthritis.org

CANADIAN RESOURCES

The Arthritis Society
http://www.arthritis.ca
Health Canada
http://www.hc-sc.gc.ca

References

Brooks RC, McGee SR. Diagnostic dilemmas in polymyalgia rheumatica. Arch Intern Med. 1997;157:1162.
Eberhardt RT, Dhadly M. Giant cell arteritis: diagnosis, management, and cardiovascular implications. Cardiol Rev. 2007;15(2):55-61.
Matteson EL, Gold KN, et al. Long-term survival of patients with giant cell arteritis in the American College of Rheumatology Giant Cell Arteritis classification criteria cohort. Am J Med. 1996;100:193.
Polymyalgia rheumatica. American College of Rheumatology website. Available at: http://www.rheumatology.org/practice/clinical/patients/diseases%5Fand%5Fconditions/polymyalgiarheumatica.asp. Updated February 2013. Accessed June 29, 2015.
Polymyalgia rheumatica (PMR). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 8, 2014. Accessed June 29, 2015.
Questions and answers about polymyalgia Rheumatical and giant cell arteritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Polymyalgia/default.asp. Updated August 2012. Accessed June 29, 2015.
Salvarani C, Cantini F, et al. Polymyalgia rheumatica and giant-cell arteritis. N Engl J Med. 2002;347:261.
Soubrier M, Dubost JJ, et al. Polymyalgia rheumatica: diagnosis and treatment. Joint Bone Spine. 2006;73(6):599-605. Review.

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