Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory condition that causes many painful muscles (poly = many, myalgia = muscle pain). PMR mainly affects the muscles of the shoulder and thigh. PMR can start at any age from 50 but usually affects people over the age of 60. Women are affected 2–3 times as often as men and it affects about 1 in 2,000 people overall.

Symptoms are severe and painful stiffness, often worse in the morning, especially in shoulders and thighs and usually affecting both sides. PMR often strikes suddenly, appearing over a week or two and sometimes just after a flu-like illness. Other symptoms include feeling generally unwell, fever, weight loss and overwhelming tiredness.

The symptoms are quite different from the ache felt after exercise. The pain and stiffness is often widespread, is worse when resting and improves with activity or as the day goes on and may be severe enough to interrupt sleep.

PMR is sometimes associated with painful inflammation of the arteries of the skull. This is called giant cell arteritis (GCA) or temporal arteritis and needs prompt treatment as there’s a risk of damage to the arteries of the eyes. About 20% of people with PMR also develop GCA, while 40–60% of people with GCA also have symptoms of PMR. The symptoms of GCA are: severe headache, tenderness at temple or jaw pain when chewing, scalp pain and blurred or double vision. Anyone with these symptoms in addition to PMR need urgent referral to rheumatology.