SUMMARY
Polymyalgia rheumatica (PMR) is a surprisingly common type of arthritis. It is an inflammatory arthritis meaning it involves a lot of inflammation and not just mechanical pain like osteoarthritis. It typically affects older patients with an average age of 70. It affects women more than men. The symptoms include severe pain and stiffness especially in the morning mostly affecting the shoulders and hips. The cause of PMR is not known. It is not life-threatening but it is associated with a more serious disease called giant cell arteritis in about 10% of cases.
DIAGNOSIS
A blood test called sedimentation rate (sed rate, ESR) helps to diagnose PMR but no one test can diagnose or exclude PMR conclusively. The diagnosis is considered clinical meaning a doctor makes the diagnose based on a combination of history and physical along with lab. Sometimes it takes a trial of treatment to determine if a patient has PMR.
WHAT TREATMENTS?
Successful treatment of PMR is one of the most dramatic things in all of medicine. Patients are treated with a steroid medicine, usually Prednisone, at relatively low doses like 10 to 20 mg. a day. If the diagnosis is correct, the patient will feel 100% better within 24 hours.
OUTLOOK
The course of PMR is typically more favorable than most types of arthritis. It usually lasts from 6 months to a year. Most patients never get this syndrome again. However, there are a minority of cases that recur or persist over time. It is important to try to prevent steroid side effects especially osteoporosis.