Unfortunately, the only clear treatment for PMR is corticosteroids. The good news is, this is generally in relatively low doses (less than 20mg). The use of steroid-sparing medications is under investigation, but so far there are no other approved therapies.
Polymyalgia Rheumatica Q & A
Polymyalgia rheumatica (PMR) is an inflammatory conditions that occurrs only in individuals over the age of 50 years. It is treated with low dose prednsione (20mg or less) and typically improves dramatically. Unfortunately, we do not have a ‘diagnostic test’ for PMR and the diagnosis is based on clinical assessment and response to prednsione. PMR can present with arthritis as a primary component but this should improve with treatment. Approximately 20% of patients with PMR are ultimately diagnosed with RA (because they can look so similar early in the disease course). If your father is still having joint symptoms than an additional cause for these symptoms (either inflammatory / RA or osteoarthritis) should be investigated and referral to a Rheumatologist is appropriate.
You may find information on polymyalgia rheumatica (PMR) on the Johns Hopkins Vasculitis Center website. http://www.hopkinsvasculitis.org
Prednisone is the standard treatment for PMR usually with a slow taper. Some patients need to be on low doses of prednisone (but sometimes only 1-2 mg/day) for several years. Your intial response is encouraging. Of course steroids do have side effects, but many of these can be decreased using lower doses and providing other agents(such as calcium, vitamin D, and potentially other agents) to protect the bones. If you have not yet seen a rheumatologist, one may be able to assist in your management.
Your doctors are right. Polymyalgia rheumatica is not a disease of young folks. If a good workup doesn’t reveal a cause right now, the usual course is to watch and wait. Often times the painful symptoms will resolve spontaneously over time. And while it is frustrating not to have a diagnosis, this is not uncommon in painful conditions.
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.
Polymyalgia rheumatica (PMR) is a clinical syndrome characterized by severe aching and stiffness in the neck, shoulder girdle, and pelvic girdle. It is classified as a rheumatic disease, although the cause is unknown.
Since this website focuses heavily on arthritis diseases, we have very little information available at this time on Polymyalgia Rheumatica that I can direct you.