Polymyalgia

POLYMYALGIA RHEUMATICA

Polymyalgia Rheumatica: body aches in many places

Polymyalgia Rheumatica (PMR) is a systemic inflammatory disorder that usually affects older adults, most often between the ages of 70 and 80.

Symptoms include widespread achiness, joint pain, and stiffness that usually occur just after waking. PMR often develops slowly over many months, but symptoms can also appear overnight. The disorder occurs more frequently in women, and in 15 percent of individuals with PMR, a serious problem called Giant Cell Arteritis (also called “Temporal Arteritis”) can also occur.

What causes Polymyalgia Rheumatica?

To date, clinical research has not identified a single underlying cause of PMR. However, there have been genetic markers which have been shown to increase the likelihood off developing PMR and GCA.  Likely culprits include the immune system malfunctioning, genetic predisposition, an infection that triggers PMR, or possibly as part of the aging process.

What are the symptoms of PMR and Giant Cell Arteritis?

According to the Arthritis Foundation, people suffering from PMR experience pain and stiffness in at least two of the following areas: lower back, hips, neck, thighs, upper arms, and shoulders. Fever and fatigue are also hallmarks of the disorder.

In Giant Cell Arteritis, inflammation develops in the temporal arteries on the side of the head, which can lead to blindness or a stroke. Symptoms include headaches on the side of the head, a tender, hot scalp, vision changes, and jaw pain while eating.

How is PMR diagnosed?

Rheumatologists have specialized training and experience to expertly diagnose and treat individuals with PMR. Obtaining an accurate diagnosis starts with a physical exam, a family and medical history, and blood tests to check for inflammation (e.g., C-reactive protein, Rheumatoid Factor, and others) to rule out rheumatoid arthritis or lupus.

What are the treatments for PMR?

Reducing inflammation and the symptoms it causes is a critical component of treating PMR. Corticosteroids such as prednisone are highly effective medications for this task. Your physician will provide explicit instructions on how to increase steroid dosages, and then reduce them, as symptoms are alleviated. Over-the-counter medications such as naproxen (sold under the brand name, ALEVE®) or ibuprofen may also be recommended to reduce pain and inflammation.  Most recently – a new, targeted biologic medication (tocilizumab, sold under the brand name – ACTEMRA®) has been shown more effective than steroids alone in helping patients with Giant Cell Arteritis.