A Form of Myalgia

Question

What is PMR, and what is the treatment?

Answer

Polymyalgia rheumatica (PMR) is a common inflammatory condition in women and men over the age of 50. It is more common in women and the incidence increases with age. It is characterized by stiffness and achiness in the shoulders, upper arms, neck and occasionally the low back. Morning stiffness greater than 45 minutes is common, together with fatigue, malaise and occasionally weight loss. Sometimes one or two joints such as a knee or wrist is swollen. Blood tests for inflammation such as sed rate and c-reactive protein are elevated. PMR invariably and dramatically responds to prednisone 10-20 mg daily initally, but generally can be tapered below 10 mg daily in the first 3-4 months. Patiets feel better after the first 2 or 3 doses. Most require prednisone for 18 to 24 months but some longer. On occasion, PMR can turn into rheumatoid arthritis. PMR can also be associated with a more serious condition called giant cell or temporal arteritis. Temporal arteritis presents with severe headache, visual problems and fever.

Alan Matsumoto, M.D.

About Alan Matsumoto, M.D.

Part-time Faculty, Division of Rheumatology
Johns Hopkins University