Polymyalgia Rheumatica

What is Polymyalgia Rheumatica?

Polymyalgia rheumatica (PMR) is a condition that causes pain and stiffness in your muscles. The name sounds complicated, but it simply means "pain in many muscles". It mainly affects the muscles around your shoulders, neck and hips.

This condition mostly affects older people - nearly everyone who gets it is over 65. It's very rare in people under 50. Women are more likely to get it than men.

What are the Symptoms?

The main sign is muscle stiffness in the morning that lasts for more than 45 minutes. This is different from the usual aches and pains that might last just a few minutes when you wake up.

Other symptoms you might notice include:

• Feeling extremely tired all the time
• Not wanting to eat much
• Losing weight without trying
• Feeling low or depressed

The pain and stiffness can make everyday tasks difficult, like getting dressed, combing your hair, or getting up from a chair.

When Should You See Your GP?

You should speak to your GP if you have pain and stiffness that lasts for more than a week. Don't wait and hope it will go away on its own.

Your GP will try to work out what's causing your symptoms. This can take time because many other conditions cause similar problems, including rheumatoid arthritis. Your doctor will need to rule out these other conditions first.

What Causes It?

Doctors don't know exactly what causes polymyalgia rheumatica. They think it's probably a mix of your genes and things in your environment that trigger it.

How is it Treated?

The main treatment is a steroid medicine called prednisolone. This helps reduce the pain and stiffness.

Your GP will usually start you on a moderate dose, then gradually reduce it over time. Most people need to take this medicine for 12 months to 2 years to stop their symptoms coming back.

A Serious Complication to Watch For

Up to 1 in 5 people with polymyalgia rheumatica can develop a more serious condition called temporal arteritis (also called giant cell arteritis). This happens when blood vessels in your head and neck become inflamed.

This is a medical emergency. Contact your GP immediately, go to 111.nhs.uk or call NHS 111 if you have any of these symptoms:

• A new headache that comes on suddenly, or headaches that happen often (your scalp might feel sore too)
• Pain in your jaw muscles or tongue when eating or talking
• Problems with your sight, like seeing double or losing vision in one or both eyes

Unlike polymyalgia rheumatica, temporal arteritis needs urgent medical attention. Without quick treatment, it can cause serious problems like stroke or blindness.

Key Points to Remember

• Polymyalgia rheumatica causes muscle pain and stiffness, especially in the morning
• It mainly affects people over 65
• Speak to your GP if symptoms last more than a week
• Treatment with steroids usually works well
• Watch out for warning signs of temporal arteritis and get urgent help if they happen

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.