Polymyalgia Rheumatica: Symptoms, Causes & Treatment

Polymyalgia rheumatica is an inflammatory disease that usually affects older adults over fifty and rarely occurs before that. It is characterized by clear pain and stiffness in the muscles of the shoulders, neck, hips, and thighs, which is most severe in the morning and after rest periods, and may make the patient find it hard to raise their arms or get up from bed or a chair.

The cause is not fully known, but it is considered an inflammatory condition linked to the immune system and often begins relatively quickly over days or weeks. It may be accompanied by general symptoms such as fatigue, low fever, loss of appetite and weight, and a general feeling of malaise. There is no single test that confirms it, but blood inflammation markers (such as ESR and C-reactive protein) are elevated and support the diagnosis along with the characteristic clinical picture after ruling out other diseases.

Among the most distinctive features of polymyalgia rheumatica is its dramatic, rapid response to low-dose corticosteroids, as most patients feel great improvement within a few days, which also supports the diagnosis. Treatment is completed by gradually tapering the dose over months with follow-up. It is very important to know that this disease may sometimes accompany a more dangerous condition called giant cell (temporal) arteritis, which causes headache, temple pain, and vision problems, and is an emergency because it may threaten sight; so any visual symptoms or a new severe headache must be noted and the doctor seen immediately.

• Pain and stiffness in the shoulders, neck, and hips, especially in the morning.
• Difficulty raising the arms or getting up from bed.
• Fatigue, low fever, and loss of appetite and weight.
• Warning signs of temporal arteritis: new headache, temple pain, vision change.

• An inflammatory condition linked to the immune system, with an unknown exact cause.
• Increases with age (over 50).
• May be linked to genetic and environmental factors.

• Clinical assessment of the characteristic symptoms in older adults.
• Inflammation-marker tests (ESR, C-reactive protein).
• Ruling out other diseases, and the rapid response to corticosteroids supports the diagnosis.

Corticosteroids

• Low-dose corticosteroids give rapid, dramatic improvement within days.
• Gradually tapering the dose over months with follow-up and avoiding sudden stopping.

Supportive care

• Protecting the bones from osteoporosis during prolonged corticosteroid treatment.
• Watching for giant-cell-arteritis symptoms and treating them urgently.

This content is educational and does not replace consulting a rheumatologist.

• Giant cell (temporal) arteritis that may threaten sight.
• Effects of prolonged corticosteroid treatment such as osteoporosis and high sugar.
• Relapse with rapid dose tapering.

• There is no prevention of the disease itself.
• Adhering to the corticosteroid-tapering plan to avoid relapse.
• Regular follow-up and watching for giant-cell-arteritis symptoms.