Polymyalgia rheumatica

Polymyalgia rheumatica (PMR) is a condition that causes muscle pain and stiffness.  The symptoms may be most notable in older people who have these symptoms in the hips or shoulders.  They may be symptoms that are more apparent in the morning, and for that reason this condition is often confused with other kinds of arthritis.

PMR may be suspected based on the history of the symptoms and a bedside exam.  Blood tests are also helpful. These are a complete blood count, ESR or sed rate, and CRP measurement.

Treatment of PMR is normally manageable with NSAID medications for pain and corticosteroids.  Relapses of this condition are common, and sometimes small doses of steroids are used for a long time.  Because of the risk of side effects of steroids, treatment with calcium and vitamin D supplements is often recommended.

There is a related condition to PMR that causes headaches, blurred vision, and sometimes pain in the muscles we use for chewing.   This is called Giant Cell arteritis or sometimes just temporal arteritis. This condition is a medical emergency because of the risk of visual loss.  This condition also is treated by corticosteroids, and often a blood test and arterial biopsy are used to make the diagnosis.