Polymyalgia rheumatica
Polymyalgia rheumatica (PMR) is an inflammatory condition that causes muscle pain and stiffness, particularly in the shoulders, neck and hips. It almost always occurs in adults over 50 and is more common in women.
Symptoms typically come on quickly, sometimes over a few days, and include:
- Pain and stiffness in the shoulders, neck and hips, often worse in the morning
- Difficulty raising the arms above shoulder height
- Fatigue and general feeling of being unwell
The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are blood markers of inflammation commonly used to help diagnose PMR and monitor treatment response. Both are typically raised significantly in active disease.
PMR is closely associated with giant cell arteritis (temporal arteritis), a more serious condition that requires urgent treatment. Corticosteroids are the standard treatment and usually produce a rapid improvement in symptoms.
Causes of Polymyalgia rheumatica
The exact cause of polymyalgia rheumatica is unknown. It is believed to involve the immune system producing inflammation in the lining of the joints and surrounding tissues, though the trigger for this response has not been identified.
Several factors may contribute:
- Age is the strongest risk factor. PMR almost exclusively affects people over 50, with peak incidence between 70 and 80
- Genetics appear to play a role, with certain HLA gene variants being more common in people with PMR
- Environmental triggers such as viral infections have been proposed as potential initiators in genetically susceptible individuals, though no specific virus has been confirmed
- Sex, with women being affected approximately twice as often as men
Around 15 to 20% of people with PMR also develop giant cell arteritis, an inflammatory condition affecting the large arteries, particularly those in the head. New onset of headache, jaw pain when chewing or visual disturbance in someone with PMR requires urgent medical assessment.
Tests that can help check this condition
Learn more on the official NHS page .
