Polymyalgia Rheumatica
A disorder involving pain in the hip area and stiffness, or shoulder pain and stiffness.
Causes, incidence, and risk factors
Information about Polymyalgia Rheumatica
Polymyalgia rheumatica is a disorder that almost always occurs in persons over 50 years
old. The cause is unknown. Although symptoms are located predominantly in the muscles and
there are no outward signs of arthritis, in some cases there is evidence of inflammatory
arthritis.
The disorder may occur independently, or it may coexist with or precede giant cell
arteritis, which is an inflammation of blood vessels (usually in the head).
Symptoms of Polymyalgia Rheumatica
hip pain and hip stiffness
shoulder pain and shoulder stiffness
neck pain and neck stiffness
muscle pain (minimal, less common than aching)
fever
weight loss
anemia
fatigue (excessive tiredness)
general ill feeling (malaise)
face pain
other joint pain
Note: Symptoms usually begin abruptly.
Diagnosis of Polymyalgia Rheumatica
Fever may be the only symptom in some cases (the person has a fever of unknown origin).
Signs of giant cell arteritis may also be present.
Blood tests are nonspecific.
The sedimentation rate (ESR) is often elevated.
Creatine kinase (CPK) is normal.
Hemoglobin or hematocrit may be normal or low.
Treatment of Polymyalgia Rheumatica
Polymyalgia rheumatica responds dramatically to cortisone-like drugs in modest doses.
In fact, one part of confirming the diagnosis is to observe the response to this
treatment. It may also respond to non-steroidal anti-inflammatory drugs (NSAIDs). Temporal
arteritis is also treated with cortisone, but in higher doses.
Prognisis of Polymyalgia Rheumatica
Polymyalgia rheumatica usually resolves by itself, even when not treated, in 1 to 4
years. Symptoms diminish greatly with treatment.
Complications Return to top
Polymyalgia rheumatica may precede giant cell arteritis or other disorders.
Calling your health care provider Return to top
Call for an appointment with your health care provider if you experience persistent
weakness or stiffness of the pelvis or shoulder, especially if this is accompanied by
symptoms of general illness (fever or headache). |
Polymyalgia rheumatica
Author/s: J. Ricker Polsdorfer
Definition of Polymyalgia Rheumatica
Polymyalgia rheumatica is a syndrome which causes pain and stiffness in the hips and
shoulders of people over the age of 50.
Description of Polymyalgia Rheumatica
Allthough the major characteristics of this condition are just pain and stiffness,
there are reasons to believe it is more than just old-fashioned rheumatism. Patients are
commonly so afflicted that their muscles atrophy from disuse. A common complaint of such
weakness is also seen in serious muscle diseases. Moreover, some patients develop
arthritis or a disease called giant cell arteritis or temporal arteritis.
Causes & symptoms of Polymyalgia Rheumatica
This condition may arise as often as once in every 2,000 people. Rarely does it affect
people under 50 years old. The average age is 70; women are afflicted twice as often as
men. Along with the pain and stiffness of larger muscles, headache may add to the
discomfort. The scalp is often tender. Pain is usually worse at night. There may be fever
and weight loss before the full disease appears. Patients complain that stiffness is worse
in the morning and returns if they have been inactive for any period of time, a condition
called gelling. Sometimes the stiffness is severe enough to cause a frozen shoulder.
Diagnosis of Polymyalgia Rheumatica
Symptoms have usually been present for over a month by the time patients seek medical
attention. There is often a mild anemia present. One blood test, called an erythrocyte
sedimentation rate is very high, much more so than in most other diseases. The most
important issue in evaluating polymyalgia rheumatica is to check for giant cell arteritis.
Untreated, giant cell arteritis can lead to blindness.
Treatment of Polymyalgia Rheumatica
Polymyalgia rheumatica responds dramatically to cortisone-like drugs in modest doses.
In fact, one part of confirming the diagnosis is to observe the response to this
treatment. It may also respond to non-steroidal anti-inflammatory drugs (NSAIDs). Temporal
arteritis is also treated with cortisone, but in higher doses.
Prognosis of Polymyalgia Rheumatica
The disease often remits after a while, with no further treatment required. |
