Polymyalgia rheumatica
Polymyalgia rheumatica (PMR) is a syndrome experienced as pain or stiffness, usually in the neck, shoulders, upper arms, and hips, but which may occur all over the body. The pain can be sudden or can occur gradually over a period. Most people with PMR wake up in the morning with pain in their muscles; however, cases have occurred in which the person has developed the pain during the evenings or has pain and stiffness all day long.
| Polymyalgia rheumatica | |
|---|---|
| In polmyalgia rheumatica, pain is usually located in the shoulders and hips. | |
| Specialty | Rheumatology |
| Symptoms | Shoulder, neck and hip pain |
| Usual onset | Age greater than 50 |
| Diagnostic method | Elevated inflammatory markers, CRP and ESR |
| Differential diagnosis | Myositis, giant cell arteritis |
| Medication | Corticosteroids |
People who have polymyalgia rheumatica may also have temporal arteritis (giant cell arteritis), an inflammation of blood vessels in the face which can cause blindness if not treated quickly. The pain and stiffness can result in a lowered quality of life, and can lead to depression. It is thought to be brought on by a viral or bacterial illness or trauma of some kind, but genetics play a role as well. Persons of Northern European descent are at greater risk. There is no definitive laboratory test, but C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can be useful.
PMR is usually treated with corticosteroids taken by mouth. Most people need to continue the corticosteroid treatment for two to three years. PMR sometimes goes away on its own in a year or two, but medications and self-care measures can improve the rate of recovery.
PMR was first established as a distinct disease in 1966 by a case report on 11 patients at Mount Sinai Hospital in New York City. It takes its name from the Greek word Πολυμυαλγία polymyalgia, which means "pain in many muscles".