Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders. Symptoms of polymyalgia rheumatica (pol-e-my-AL-juh rue-MAT-ih-kuh) usually begin quickly and are worse in the morning. Most people who develop polymyalgia rheumatica are older than 65. It rarely affects people under 50.

You may receive symptom relief by taking anti-inflammatory drugs called corticosteroids. But relapses are common, and you'll need to visit your doctor regularly to watch for serious side effects of these drugs.

Polymyalgia rheumatica is related to another inflammatory disorder called giant cell arteritis, which can cause headaches, vision difficulties, jaw pain and scalp tenderness. It's possible to have both of these conditions together.


The signs and symptoms of polymyalgia rheumatica usually occur on both sides of the body and may include:

  • Aches or pain in your shoulders (often the first symptom)
  • Aches or pain in your neck, upper arms, buttocks, hips or thighs
  • Stiffness in affected areas, particularly in the morning or after being inactive for a long time
  • Limited range of motion in affected areas
  • Pain or stiffness in your wrists, elbows or knees (less common)

You may also have more general signs and symptoms, including:

  • Mild fever
  • Fatigue
  • A general feeling of not being well (malaise)
  • Loss of appetite
  • Unintended weight loss
  • Depression

When to see a doctor

See your doctor if you experience aches, pains or stiffness that:

  • Is new
  • Disrupts your sleep
  • Limits your ability to do your usual activities of daily living, such as getting dressed


The exact cause of polymyalgia rheumatica is unknown. Two factors appear to be involved in the development of this condition:

  • Genetics. Certain genes and gene variations may increase your susceptibility.
  • An environmental exposure. New cases of polymyalgia rheumatica tend to come in cycles and may develop seasonally. This suggests that an environmental trigger, such as a virus, might play a role. But no specific virus has been shown to cause polymyalgia rheumatica.

Giant cell arteritis

Polymyalgia rheumatica and another disease known as giant cell arteritis share many similarities. Giant cell arteritis results in inflammation in the lining of arteries, most often the arteries located in the temples. Giant cell arteritis can cause headaches, jaw pain, vision problems and scalp tenderness. If left untreated, it can lead to stroke or blindness.

Polymyalgia rheumatica and giant cell arteritis may actually be the same disease but with different manifestations. The overlap between the two diseases is significant:

  • About 20 percent of people with polymyalgia rheumatica also have signs and symptoms of giant cell arteritis.
  • About half of the people with giant cell arteritis may also have polymyalgia rheumatica.

Risk factors

Risk factors for polymyalgia rheumatica include:

  • Age. Polymyalgia rheumatica affects older adults almost exclusively. The average age at onset of the disease is 73.
  • Sex. Women are about two times more likely to develop the disorder.
  • Race and geographic region. Polymyalgia rheumatica is most common among whites in northern European populations.


Symptoms of polymyalgia rheumatica can greatly affect your ability to perform everyday activities. The pain and stiffness may contribute to difficulties with tasks such as the following:

  • Getting out of bed, standing up from a chair or getting out of a car
  • Bathing or combing your hair
  • Getting dressed or putting on a coat

These difficulties can affect your health, social interactions, physical activity, sleep and general well-being.

In addition, people with polymyalgia rheumatica seem to be more likely to develop peripheral arterial disease.

Sept. 17, 2015
  1. Kermani TA, et al. Polymyalgia rheumatica. The Lancet. 2013;381:63.
  2. AskMayoExpert. Polymyalgia rheumatica. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  3. Bhaskar D, et al. 2012 provisional classification criteria for polymyalgia rheumatica: A European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis & Rheumatism. 2012;64:943.
  4. Kermani TA, et al. Advances and challenges in the diagnosis and treatment of polymyalgia rheumatica. Therapeutic Advances in Musculoskeletal Disease. 2014;6:8.
  5. Wyand CM, et al. Giant-cell arteritis and polymyalgia rheumatica. New England Journal of Medicine. 2014;371:50.
  6. Salvarani C, et al. Clinical features of polymyalgia rheumatica and giant cell arteritis. Nature Reviews Rheumatology. 2012;8:509.
  7. Matteson EL, et al. Diagnosis and assessment of polymyalgia rheumatica: A step forward. Aging Health. 2012;8:395.
  8. Aikawa NE, et al. Anti-TNF therapy for polymyalgia rheumatica: Report of 99 cases and review of the literature. Clinical Rheumatology. 2012;31:575.
  9. Glucocorticosteroid-induced osteoporosis. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gi-osteoporosis.asp. Accessed May 1, 2015.
  10. Saag KG, et al. Major side effects of systemic glucocorticoids. www.uptodate.com/home. Accessed May 7, 2015.
  11. Colditz GA. Healthy diet in adults. www.uptodate.com/home. Accessed May 18, 2015.
  12. Dejaco C, et al. 2015 recommendations for the management of polymyalgia rheumatic. Arthritis & Rheumatology. 2015;67:2569.