Polymyalgia rheumatica

DEFINITION

Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness. The pain and stiffness often occur in your shoulders, neck, upper arms and hips. Symptoms of polymyalgia rheumatica (pol-ee-my-AL-juh roo-MA-ti-kah) usually begin quickly, within two weeks.

Most people who develop polymyalgia rheumatica are older than 65. It rarely affects people younger than 50.

Anti-inflammatory drugs called corticosteroids improve the symptoms of polymyalgia rheumatica, but these drugs require careful monitoring for serious side effects.

Polymyalgia rheumatica is related to another inflammatory disorder called giant cell arteritis, which can cause headaches, vision difficulties, jaw pain and other symptoms. It’s possible to have both of these conditions together.

CAUSES

The exact cause of polymyalgia rheumatica is unknown. However, there are two factors that appear to be involved in the development of this condition, including:

• Genetics. Certain genes and variations in some genes may increase your susceptibility to developing polymyalgia rheumatica.
• An environmental exposure. New cases of polymyalgia tend to come in cycles and may develop seasonally, which suggests that an environmental trigger, such as a virus, might play a role. But no specific virus has been shown to cause polymyalgia rheumatica.

Giant cell arteritis

Polymyalgia rheumatica and another disease known as giant cell arteritis share many similarities. Giant cell arteritis results in inflammation in the lining of arteries, most often the arteries located in the temples. Giant cell arteritis usually causes headaches, jaw pain, vision problems and scalp tenderness. It can lead to permanent vision loss.

Polymyalgia rheumatica and giant cell arteritis may actually be the same disease but with different manifestations. The overlap between the two diseases is significant:

• As many as 30 percent of people with polymyalgia rheumatica may also have giant cell arteritis.
• About half of the people with giant cell arteritis may also have polymyalgia rheumatica.

SYMPTOMS

The signs and symptoms of polymyalgia rheumatica usually occur on both sides of the body and may include:

• Aches or pain in your shoulders (often the first symptom)
• Aches or pain in your neck, upper arms, buttocks, hips or thighs
• Stiffness in affected areas, particularly in the morning or after being inactive for a long time, such as a long car ride
• Limited range of motion in affected areas
• Pain or stiffness in wrists or knees (less common)

You may also have more general signs and symptoms, including:

• Mild or low-grade fever
• Fatigue
• A general feeling of not being well (malaise)
• Loss of appetite
• Unintended weight loss
• Depression

When to see a doctor

See your doctor if you experience aches, pains or stiffness that:

• Is new
• Disrupts your sleep
• Limits your ability to do activities of daily living, such as getting dressed or going up and down stairs