Polymyalgia rheumatica

Polymyalgia rheumatica
In polymyalgia rheumatica, pain is usually located in the shoulders and hips.
SpecialtyRheumatology
SymptomsShoulder, neck and hip pain[1]
Usual onsetAge greater than 50
Diagnostic methodElevated inflammatory markers, CRP and ESR
Differential diagnosisMyositis, giant cell arteritis
MedicationCorticosteroids

Polymyalgia rheumatica (PMR) is a syndrome experienced as pain or stiffness, usually in the neck, shoulders, upper arms, and hips, but which may occur all over the body. The pain can be sudden or can occur gradually over a period. Most people with PMR wake up in the morning with pain in their muscles; however, cases have occurred in which the person has developed the pain during the evenings or has pain and stiffness all day long.[1][2]

People who have polymyalgia rheumatica may also have temporal arteritis (giant cell arteritis), an inflammation of blood vessels in the face which can cause blindness if not treated quickly.[3] The pain and stiffness can result in a lowered quality of life, and can lead to depression.[1] It is thought to be brought on by a viral or bacterial illness or trauma of some kind, but genetics play a role as well.[4] Persons of Northern European descent are at greater risk.[4] There is no definitive laboratory test, but C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can be useful.

PMR is usually treated with corticosteroids taken by mouth.[5] Most people need to continue the corticosteroid treatment for two to three years.[6] PMR sometimes goes away on its own in a year or two, but medications and self-care measures (e.g., eating the recommended amount of fruits and vegetables) can improve the rate of recovery.[7]

PMR was first established as a distinct disease in 1966 by a case report[8] on 11 patients at Mount Sinai Hospital in New York City.[9] It takes its name from the Greek word Πολυμυαλγία polymyalgia, which means "pain in many muscles".

  1. ^ a b c "Polymyalgia Rheumatica". National Institute of Arthritis and Musculoskeletal and Skin Diseases. April 11, 2017. Retrieved February 10, 2021.
  2. ^ Gelfand JL (November 18, 2007). "Polymyalgia Rheumatica and Temporal Arteritis". WebMD. Retrieved June 10, 2008.
  3. ^ Schmidt J, Warrington KJ (August 1, 2011). "Polymyalgia rheumatica and giant cell arteritis in older patients: diagnosis and pharmacological management". Drugs & Aging. 28 (8): 651–66. doi:10.2165/11592500-000000000-00000. PMID 21812500. S2CID 44787949.
  4. ^ a b Cimmino MA (1997). "Genetic and environmental factors in polymyalgia rheumatica". Annals of the Rheumatic Diseases. 56 (10): 576–577. doi:10.1136/ard.56.10.576. PMC 1752263. PMID 9389216.
  5. ^ Dejaco C, Singh YP (October 2015). "2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative". Annals of the Rheumatic Diseases. 74 (10): 1799–807. doi:10.1136/annrheumdis-2015-207492. hdl:2445/115060. PMID 26359488.
  6. ^ "Polymyalgia Rheumatica treatments and drugs". MayoClinic. December 4, 2010. Retrieved January 19, 2012.
  7. ^ "Polymyalgia Rheumatica definition". MayoClinic. May 17, 2008. Archived from the original on June 23, 2008. Retrieved January 19, 2012.
  8. ^ Davison S, Spiera H, Plotz CM (February 1966). "Polymyalgia rheumatica". Arthritis and Rheumatism. 9 (1): 18–23. doi:10.1002/art.1780090103. PMID 4952416.
  9. ^ Plotz, Charles; Docken, William (May 2013). "Letters: More on the History of Polymyalgia Rheumatica and Giant Cell Arteritis". The Rheumatologist. ACR/ARHP. Archived from the original on February 12, 2015. Retrieved June 1, 2014.