Polymyalgia rheumatica means “pain in many muscles” and is a common condition in older adults that causes musculoskeletal stiffness and pain. The expert team at ArthritisCARE offers individualised and holistic management plans to improve your pain and health.

What is polymyalgia rheumatica?

 

Polymyalgia rheumatica (PMR) is a condition that causes inflammation of the larger joints in your body and surrounding tissues. This inflammatory disorder causes all-over body aches, stiffness, and pain, especially targeting your shoulder, neck, and hip areas.

Polymyalgia rheumatica treatment

Polymyalgia rheumatica (PMR) is a type of arthritis that causes inflammation in large joints and muscles, resulting in areas of your body, especially your neck, shoulders, and hips, feeling painful and stiff.

What causes it?

The exact cause of PMR is unknown at this time; however, it is thought to be an autoimmune inflammatory condition. This means your immune system attacks otherwise healthy tissue, causing pain and inflammation.

Although not proven as yet, it is believed by many doctors and Rheumatologists that there may be environmental factors, such as infection or viruses, and genetic factors that play roles in the development of PMR.

What are the signs and symptoms
of polymyalgia rheumatica?

The signs and symptoms of PMR usually come on quickly, over several days or weeks, or sometimes even overnight.

The main complaints PMR has are:

  • Symmetrical (same joints or muscles on either side of your body) muscle pain and stiffness are more common in the upper arms, shoulders, neck, buttocks, and thighs.
  • Morning stiffness, pain, and muscle tension
  • Pain and stiffness are worse after being still for long periods of time or sitting too long in the same position.
  • Fatigue.
  • Difficulty sleeping due to discomfort.
  • Unexplained weight loss and poor appetite.
  • Difficulty lifting your arms above shoulder height due to stiffness and/or pain.
  • Struggling to perform daily activities such as putting on shoes or standing from a low chair due to joint pain and/or stiffness.

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The complication of PMR: Giant Cell Arteritis

Rarely (about one in five) do people with PMR develop a serious condition known as giant cell arteritis or temporal arteritis. This is the result of the blood vessels, usually on the side of your head, becoming inflamed and causing reduced blood flow.

Symptoms of giant cell arteritis:

If left untreated, giant cell arteritis can cause permanent damage and long-term health complications. If you have any of the following symptoms, you need to see a doctor immediately:

  • persistent headaches, especially on the side of your head.
  • Visual changes such as blurry or double vision
  • Pain in the muscles of your jaw when chewing
  • sore or swollen side of your head
Polymyalgia rheumatica treatment

Giant cell arteritis, a complication of PMR, can cause persistent headaches, troubles with your vision, painful chewing, and a swollen or painful side of your head.

How do we diagnose polymyalgia rheumatica?

There is no single test to diagnose polymyalgia rheumatica; rather, it is based on a physical examination, your presenting symptoms of pain and morning stiffness, your medical history, and various blood tests. Blood tests are generally used to rule out a different type of arthritis, autoimmune disease, or an inflammatory condition such as rheumatoid arthritis or systemic lupus erythematosus (Lupus).

You may be ordered blood tests such as erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), which measure levels of inflammation. However, these can appear as normal blood tests in people with PMR.

Our Rheumatologists at ArthritisCARE are experts at diagnosing complex cases using physical examination and differentiating between conditions to determine the type of arthritis or inflammatory condition that is causing your symptoms. It may take several visits with our Rheumatologists to rule out other diseases before a diagnosis of PMR is made.

What treatment options are there for polymyalgia rheumatica?

The gold standard of treatment for PMR involves medicines called corticosteroids that manage pain and reduce inflammation. You will be started on a higher dose until your symptoms start to resolve, and then we will work with you to slowly reduce your dose to the lowest possible amount that keeps you symptom-free.

Our Rheumatologists, or your doctor, will review you on a regular basis, as corticosteroids can have some side effects.

Other medications and methods to treat PMR:

Occasionally, you may be prescribed other medications as part of your management plan for PMR.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Paracetamol
  • Vitamin D

We also suggest gentle exercises such as walking, riding, or hydrotherapy to improve muscle strength and function and maintain joint flexibility.

The good news is that PMR does not cause any permanent damage to the affected joint. In fact, most people find their symptoms dramatically improving a few days after starting therapy. It can take several months to three years for your symptoms to fully resolve, but after that, you may be able to decrease your dose or even stop taking the medication.

How much does it cost for polymyalgia rheumatica
treatment in Brisbane?

The cost to see a Rheumatologist for PMR diagnosis and management will vary depending on the tests and therapy you require. You can find up-to-date pricing and further information in the Frequently Asked Questions section of our website.

Why choose the ArthritisCARE team
for your polymyalgia rheumatica treatment in Brisbane?

ArthritisCARE Rheumatologists

Here at ArthritisCARE, we understand how debilitating joint and muscle pain can be and the negative impact it may have on your daily life. We treat every patient with compassion and care as we work with you to diagnose and manage pain. Our Rheumatologists are experienced with PMR and ensure we tailor individualised and holistic management plans to alleviate your symptoms.

From your first appointment right through your recovery from PMR, we are here to help you every step of the way.

Meet Dr. Peter Landsberg

Our founder, Dr Peter Landsberg, has brought together a team of experienced, dedicated rheumatologists and support staff. We work in a collaborative and caring environment, creating optimal outcomes for our patients. Dr Peter Landsberg has a passion for treating connective tissue disorders and inflammatory arthritis.

 

How to contact us

Find a polymyalgia rheumatica specialist near me:

FAQs

You can find further information and questions about PMR below:

The best painkiller for PMR is a corticosteroid medication. This reduces the inflammation that causes muscle discomfort and stiffness. You can also take simple analgesics such as paracetamol; however, this only masks the pain and doesn’t treat the underlying cause.
The long-term management for PMR is corticosteroids. Most people have great results with these medications, with full resolution of their symptoms anywhere from several months to three years.
If PMR goes untreated or undiagnosed, your mobility and ability to perform daily tasks may be significantly impacted due to inflammation, joint pain, and stiffness. You may find your muscle strength begins to weaken, and lifting your arms over your head becomes difficult. If you suspect, or your GP suspects, that you have PMR, it is best to see a Rheumatologist as soon as possible for an accurate diagnosis and early intervention.
PMR is not a serious condition; however, it does put you at an increased risk of developing a serious complication known as giant cell arteritis or temporal arteritis. Giant-cell arteritis causes the blood vessels in your head to become inflamed, reducing blood flow. If you have PMR and develop persistent headaches, visual disturbances, or jaw pain when eating, you should see your GP or another doctor immediately.
Yes, you can fully recover from PMR. With a course of corticosteroids, we generally see patients make full recovery over several months to years. Occasionally they may have relapses, but if they maintain general health and a healthy diet, they can stay symptom-free.

It is thought there are several factors that play a role in triggering PMR:

  • environmental factors such as infections, viruses, or pollutants.
  • Genetic factors.
  • the aging process (most people are over the age of 50 when diagnosed).
No, PMR is not a form of rheumatoid arthritis (RA). They may present similar symptoms, but the disease process is different, and they are not the same. Although both diseases are inflammatory autoimmune diseases, RA causes painful joints, whereas PMR is felt more in your muscles.
No. Although both of these conditions cause widespread pain and stiffness, PMR and fibromyalgia are different. PMR causes inflammation, whereas fibromyalgia doesn’t.
The exact cause of PMR is not known; however, it is believed to be an autoimmune disease triggered by genetic, age, or environmental factors. These factors trigger your body’s immune system to attack the healthy tissue surrounding your joint, causing inflammation and muscle pain.
It has not been proven that PMR is hereditary, although there may be a genetic predisposition to developing this condition. If you possess the HLA-DR4 gene (also associated with RA), this gene can be triggered, resulting in PMR.
When giant cell arteritis (temporal arteritis or cranial arteritis) occurs as a complication of PMR, your eyes may be affected. This causes swelling and inflammation in the vessels supplying blood to your head and brain and can result in visual disturbances, headaches, a tender scalp, and jaw pain when chewing.
 

Recommended further advice is available from:

Arthritis Australia’s Polymyalgia Rheumatica Resources page
https://arthritisaustralia.com.au/types-of-arthritis/polymyalgia-rheumatica/

Information Sheet: Polymyalgia Rheumatica by Arthritis Australia
https://arthritisaustralia.com.au/wordpress/wp-content/uploads/2017/09/ArthAus_PolymyalgiaRheumatica_2405.pdf

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If you’re suffering from joint pain, stiffness, or other symptoms related to arthritis, lupus, or other rheumatic conditions, we are here to help. Our team of experienced Rheumatologists is dedicated to providing personalized care and effective treatment options that can help alleviate your pain and improve your quality of life.

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