Polymyalgia Rheumatica

Polymyalgia Rheumatica is an inflammatory condition of unknown cause that afflicts older people causing aching and stiffness in the neck, upper arms, shoulders and the low back, hips, and thighs. The symptoms occur on both sides of the body and the stiffness is typically worse in the AM, lasting more than 30 minutes. Onset of symptoms occurs over a period of days to weeks and can be accompanied by fatigue, loss of appetite, weight loss, or fever. The average age of onset is 70 and the condition is very rare in someone under 50. It affects women slightly more than men, all races, and is more common than rheumatoid arthritis. The condition is diagnosed when the patient has compatible symptoms and elevated inflammation tests in the blood including an erythrocyte sedimentation rate (sed rate) and/or C-reactive protein (CRP). Treatment is low dose corticosteroids, typically prednisone, 10 to 20 mg a day initially which in most cases produces a dramatic reduction of symptoms within a few days. When symptoms and the inflammatory markers are controlled the steroids are very gradually decreased. Recurrent symptoms as the cortisone dose is tapered are not unusual but Polymyalgia Rheumatica will typically run its course over 1-3 years and corticosteroids can eventually be discontinued. Some patients with Polymyalgia Rheumatica will have an associated condition called Giant Cell Arteritis and the physician diagnosing and managing Polymyalgia Rheumatica should be alert to symptoms and physical findings that might suggest its presence as its treatment and course are different than for Polymyalgia Rheumatica alone.