Polymyalgia rheumatica

• Causes, incidence, and risk factors

  Polymyalgia rheumatica is a disorder that almost always occurs in people over 50 years old. The cause is unknown. Although symptoms are located mainly in the muscles and there are no outward signs of arthritis, in some cases there is evidence of inflammatory arthritis.

  The disorder may occur alone, or with or before temporal arteritis, which is an inflammation of blood vessels (usually in the head).

• Symptoms
  • Anemia (low number of red blood cells in the blood)
  • Face pain
  • Fatigue (excessive tiredness)
  • Fever
  • Hip pain and stiffness
  • Malaise (general ill feeling)
  • Muscle pain (minimal, less common than aching)
  • Neck pain and stiffness
  • Other joint pain
  • Shoulder pain and stiffness
  • Unintentional weight loss

  Note: Symptoms usually come on suddenly.

• Signs and tests

  Fever may be the only symptom in some cases (the person has a fever for no known reason). There may also be signs of temporal arteritis.

  Blood tests are nonspecific.

  • Creatine kinase (CPK) is normal
  • Hemoglobin or hematocrit may be normal or low
  • The sedimentation rate (ESR) is often elevated
• Treatment

  The goal of treatment is relief of discomfort and stiffness. The disease can be very bothersome if it is not treated. Corticosteroids, such as prednisone, are prescribed in low doses.

• Expectations (prognosis)

  Polymyalgia rheumatica usually goes away by itself, even when not treated, in 1 to 4 years. Symptoms diminish greatly with treatment. Most patients need steroid treatment for 1 or more years.

• Complications

  Polymyalgia rheumatica may occur before the onset of giant cell arteritis or other disorders.

• Calling your health care provider

  Call for an appointment with your health care provider if you experience persistent weakness or stiffness of the pelvis or shoulder, especially if this is accompanied by symptoms of general illness, such as fever or headache.

• Prevention

  There is no known prevention.

• References
  Unwin B, Williams CM, Gilliland W. Polymyalgia Rheumatica and Giant Cell Arteritis. Am Fam Physician; 2006; 74(9):1547-1554.

Review Date: 2/22/2009

Reviewed By: Ariel D. Teitel, MD, MBA, Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.