HealthInfo Waitaha Canterbury
Polymyalgia rheumatica (PMR)
Mate uaua mārō
Polymyalgia rheumatica (PMR) is a condition that causes inflammation, pain and stiffness in your shoulders, neck and hips.
We do not know what causes PMR, but it mainly affects people over 60. Some people with PMR develop a more serious condition called giant cell arteritis (GCA).
The symptoms of PMR vary between people, but generally include:
- pain, aching and tenderness in your neck, shoulders, hips, buttocks and thighs
- stiffness in the morning, getting better after around 30 to 40 minutes
- pain when moving your joints
- sometimes, other general symptoms such as tiredness, weight loss, fever and loss of appetite.
Important
If your symptoms include a sudden headache, tenderness around your scalp, pain in your jaw when chewing or changes in your eyesight, see your general practice team as soon as possible. These are signs of giant cell arteritis (GCA).
Diagnosing PMR
Your doctor will ask you about your symptoms and how long you have had them. They will want to make sure you do not have GCA. They will also want to rule out other health conditions, such as fibromyalgia and osteoarthritis.
There is no single test to diagnose PMR. But your doctor will want you to have blood tests to look for inflammation in your body. They will usually make a diagnosis based on your symptoms combined with your blood test results. If your doctor is unsure about a diagnosis, they may refer you to see a rheumatologist for more tests. This is especially likely if you are younger than 50.
Treating PMR
If your doctor diagnoses you with PMR, they will start you on a steroid medication called prednisone straight away. The medication works by reducing your inflammation. You should see an improvement within a few days. Your doctor will monitor your progress to check if your symptoms are improving. They will adjust your dose if necessary.
You usually start taking 15 to 20 mg of prednisone daily and stay at this dose for at least a month. When your symptoms improve, your doctor will gradually reduce the dosage. Often people need to keep taking a low dose of prednisone for several years to stop the PMR from coming back.
Steroids can reduce your bone density and may cause osteoporosis. Your doctor will usually give you advice about trying to prevent this.
If your PMR does not respond well to prednisone or you need high doses, you may be referred to a rheumatologist. They may consider other medication such as methotrexate or azathioprine.
HealthInfo recommends the following pages
- Arthritis New Zealand – Polymyalgia rheumatica
Information about PMR and support for people with arthritis.
Written by HealthInfo clinical advisers. Last reviewed July 2024.
Sources
Review key: HIPMR-18669
