Polymyalgia rheumatica

What is polymyalgia rheumatica?

Polymyalgia rheumatica is a type of arthritis where you have inflammation in the shoulder joints and sometimes in the hip joints, as well as in the surrounding tissues. It can make your muscles feel painful and stiff, especially in your shoulders, neck and hips. It usually affects older adults. However, when treated, your symptoms can improve rapidly and may eventually disappear altogether.

What causes polymyalgia rheumatica?

Doctors do not know what causes polymyalgia rheumatica. Some doctors have suggested that polymyalgia rheumatica may be genetic. Sometimes an infection might trigger your condition, but there isn’t any clear proof of this.

What are the symptoms of polymyalgia rheumatica?

Polymyalgia rheumatica simply means ‘pain in many muscles’. Your main symptoms might include:

• pain and stiffness in your shoulders and sometimes also in your neck, buttocks and thighs
• feeling worse in the morning or after sitting still for a while, for example after a long car ride
• difficulty lifting your arms up

Your muscular pain can come on overnight, or it can come on slowly. It might be mild, or it might be severe enough to make it difficult to function.

You might also have other symptoms such as:

• feeling unwell
• mild fever
• weight loss
• difficulty sleeping
• depression
• feeling very tired

If you are concerned about any of these symptoms, see your doctor.

What is giant cell arteritis?

If you have polymyalgia rheumatica you are at increased risk of developing a serious illness called giant cell arteritis. This is a type of blood vessel inflammation (vasculitis).

Symptoms of giant cell arteritis include:

• a severe headache
• blurred or double vision
• pain in your jaw when you chew
• soreness and tenderness in one temple (side of the forehead)

If you’re worried you may have giant cell arteritis, you should see your doctor or go to a hospital emergency department within 24 hours.

How will my doctor diagnose polymyalgia rheumatica?

Your doctor will ask about your symptoms, examine you and refer you for blood tests to check for signs of inflammation, for example, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).

There is no single test for polymyalgia rheumatica and it may take a few visits for your doctor to rule out other forms of arthritis with similar symptoms.

How is polymyalgia rheumatica treated?

If you have polymyalgia rheumatica, your doctor may prescribe corticosteroid medicines. You may need to start on a high dose to control your symptoms. Your doctor will advise you how to reduce your dose to the lowest dose you need to stay symptom-free.

You will probably find that your symptoms improve quickly after starting treatment, but you usually need to continue treatment for 1 to 2 years. You can access help and support from services for people living with chronic illness.

You may develop unwanted side effects from corticosteroids, so it is important to see your doctor regularly. To avoid these, your doctor might recommend calcium and vitamin D supplements or other medicines. You may also be able to limit the side effects by:

• eating a healthy diet
• limiting your salt intake
• exercising regularly

For some people, polymyalgia rheumatica goes away with treatment and doesn’t come back. For others, polymyalgia rheumatica affects them for life.