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Polymyalgia rheumatica (PMR) is a condition that causes inflammation, pain and stiffness in your shoulders, neck and hips. If you have PMR, you'll often also feel tired and unwell.
We don't know what causes PMR, but it mainly affects people over 60 years of age. Some people with PMR develop a more serious condition called giant cell arteritis (GCA).
Image credit: canva
The symptoms of polymyalgia rheumatica vary from person to person, but generally include:
If your symptoms include a sudden headache, tenderness around your scalp, pain in your jaw when chewing or changes in your eyesight, see your healthcare provider as soon as possible. These are signs of giant cell arteritis (GCA).
Your healthcare provider will ask you about your symptoms and how long you've had them. They'll want to make sure you don't have giant cell arteritis, and will want to rule out other conditions, such as fibromyalgia and osteoarthritis.
There's no single test to diagnose polymyalgia rheumatica, but your healthcare provider will want you to have blood tests to look for inflammation in your body. They'll usually make a diagnosis based on your symptoms and blood test results. If your healthcare provider is unsure about a diagnosis, especially if you're younger than 50, they may refer you to see a rheumatologist (a doctor who specialises in conditions affecting joints, muscles and bones) for more tests.
If your healthcare provider diagnoses you with polymyalgia rheumatica (PMR), they'll start you on a steroid medication called prednisone straight away. The medication works by reducing your inflammation, and you should see an improvement within a few days. Your healthcare provider will monitor your progress to check if your symptoms are improving, and will adjust the dose if necessary.
You usually start taking 15 to 20 mg of prednisone daily and stay at this dose for at least a month. When your symptoms improve, your healthcare provider will gradually reduce the dosage. Often people need to keep taking a low dose of prednisone for several years to stop the PMR from coming back.
As steroids can reduce your bone density and may cause osteoporosis, your healthcare provider will usually give you advice about trying to prevent this.
If your PMR doesn’t respond well to prednisone, or you need high doses, you may be referred to a rheumatologist. They may consider starting you on other medication such as methotrexate or azathioprine.
You may find it useful to look at some physiotherapy and exercise apps and pain management apps.
Investigating myalgia in patients taking statins(external link) BPAC, NZ, 2014
Polymyalgia rheumatica – look before you leap(external link) BPAC, NZ, 2023
Polymyalgia rheumatica (PMR)(external link) Clinical HealthPathways, NZ
(Musculoskeletal Health Australia, 2020)
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