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Polymyalgia rheumatica (PMR)

Polymyalgia rheumatica (PMR) is a condition that causes inflammation, pain and stiffness in your shoulders, neck, and hips. We don't 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:

If you're worried about any of these symptoms, make an appointment with your GP.

Important

If your symptoms include a sudden headache, tenderness around your scalp, or loss of vision, see your doctor as soon as possible. These are signs of GCA.

Your doctor will ask you about your symptoms and how long you've had them. They'll want to make sure you don't have GCA, and will want to rule out other health conditions, such as fibromyalgia and osteoarthritis.

There's no single test to diagnose PMR, but your doctor will want you to have some blood tests to look for inflammation in your body. They'll usually make a diagnosis based on your symptoms combined with your blood test results. If your doctor is unsure about a diagnosis, especially if you're younger than 50, they may refer you to see a rheumatologist at Grey Base Hospital, as you may need more tests.

Treatment

If your doctor diagnoses you with PMR, they'll start you on a steroid medication called prednisone straight away. The medication works by reducing your inflammation, and you should see an improvement within a few days. Your doctor will monitor your progress to check if your symptoms are improving, and to adjust the 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.

As steroids can reduce your bone density and may cause osteoporosis, your doctor will usually give you advice about trying to prevent this.

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Written by HealthInfo clinical advisers. Endorsed by rheumatologist, Department of Rheumatology, Immunology & Allergy, Canterbury DHB. Last reviewed December 2017.

Source

See also:

Conserving energy

Immunosuppression

Oral steroids

Page reference: 186589

Review key: HIPMR-18669