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What is Polymyalgia Rheumatica (PMR) ?

Painful Shoulder

Just diagnosed with Polymyalgia Rheumatica?

If you need to talk it over, call our helpline on 0300 111 5090 or order an information pack.

Polymyalgia Rheumatica (PMR) is an inflammatory condition that many people now believe may be a form of vasculitis. It is recognised to be an autoimmune illness. It causes pain, tenderness and stiffness in the large muscles around the shoulders, hips and back. It generally affects older people and is rare in people under 50. The average age of onset is around 76. Each year nearly 1 in 1,000 people over the age of 40 in the UK develop PMR, and about two thirds of these are women.

While some people recover after about two years of treatment, more recent estimates suggest it may be much longer than this for some. It is not clear why some people need treatment for so much longer than others.

What are the symptoms?

Symptoms often appear very suddenly, over just a few days, or may develop more slowly. Polymyalgia Rheumatica can be easily confused with other conditions, and is sometimes passed off as ‘the aches and pains of getting older’. Quite often several visits to the doctor are needed before the condition is diagnosed. 

You may experience:

How is it diagnosed?

There is no one unique symptom of Polymyalgia Rheumatica and no one unique blood test that confirms the diagnosis. Doctors have to think about other possible causes of the symptoms and, especially if you have lost weight, will want to rule out other serious illnesses. Your GP will take blood tests to test the ‘inflammatory markers’ in the body. The key tests are ‘ESR’ or Erythrocyte Sedimentation Rate and ‘CRP’ or C-Reactive Protein Test. Sometimes plasma viscosity is done instead of ESR.

What is the treatment?

Once diagnosed, treatment is with steroid tablets (usually Prednisolone) and symptoms can improve spectacularly. The usual recommended starting dose is 15mg daily, which is then tapered down to a lower dose which still controls the symptoms. After several months your doctor will start reducing the dosage further, with an aim to reduce it to zero. In some cases, PMR ‘burns itself out’ after a couple of years. For other people, this can take longer. While reducing steroid use, painkillers such as paracetemol can be helpful. It’s important to remember that everybody is different, and our experiences of PMR and treatment can differ from the ‘textbook’ version.

Are there any complications?

About 1 in 20 people on treatment for PMR (or 7 out of 20 people with untreated PMR) develop giant cell (or temporal) arteritis, a related condition causing inflammation of arteries (see Giant Cell Arteritis).

Consult a doctor urgently if you have PMR and you develop any of the following symptoms, as they may indicate the onset of Giant Cell Arteritis:

It is very important for everyone with PMR to be aware of the symptoms of Giant Cell Arteritis, as if left untreated it can lead to permanent vision damage.

Resources

Polymyalgia Rheumatica - booklet

Versus Arthritis is a charity that funds research as well as educates and informs the general public about different musculoskeletal conditions. They released a booklet on Polymyalgia Rheumatica (PMR) which provides answers to questions about this condition.

To download the booklet please click here

Private Rheumatologists

The following is a link to private rheumatologists in the UK.

This page was last updated: June 2019

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