Overview

Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders. Signs and 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.

This condition is related to another inflammatory called giant cell arteritis. Giant cell arteritis can cause headaches, vision difficulties, jaw pain and scalp tenderness. It's possible to have both conditions together.

Symptoms

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

  • Aches or pain in your shoulders
  • 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 time
  • Limited range of motion in affected areas
  • Pain or stiffness in your wrists, elbows or knees

You might 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 have aches, pains or stiffness that:

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

Causes

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 might increase your susceptibility.
  • An environmental exposure. New cases of polymyalgia rheumatica tend to come in cycles, possibly developing 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. Many people who have one of these diseases also have symptoms of the other.

Giant cell arteritis results in inflammation in the lining of the arteries, most often the arteries in the temples. Signs and symptoms include headaches, jaw pain, vision problems and scalp tenderness. If left untreated, this condition can lead to stroke or blindness.

Risk factors

Risk factors for polymyalgia rheumatica include:

  • Age. Polymyalgia rheumatica affects older adults almost exclusively. It most often occurs between ages 70 and 80.
  • Sex. Women are about two to three times more likely to develop the disorder.
  • Race. Polymyalgia rheumatica is most common among white people whose ancestors were from Scandinavia or northern Europe.

Complications

Symptoms of polymyalgia rheumatica can greatly affect your ability to perform everyday activities, such as:

  • Getting out of bed, standing up from a chair or getting out of a car
  • Combing your hair or bathing
  • Getting dressed

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, although it's usually mild and responds well to treatment.

June 23, 2018
References
  1. Docken WP. Clinical manifestations and diagnosis of polymyalgia rheumatic. https://www.uptodate.com/contents/search. Accessed June 3, 2018.
  2. Dejaco C, et al. Giant cell arteritis and polymyalgia rheumatica: Current challenges and opportunities. Nature Reviews: Rheumatology. 2017;13:592.
  3. Patient fact sheet: Polymyalgia rheumatic. American College of Rheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Polymyalgia-Rheumatica. Accessed June 3, 2018.
  4. Docken WP. Treatment of polymyalgia rheumatic. https://www.uptodate.com/contents/search. Accessed June 3, 2018.
  5. Polymyalgia rheumatic. Arthritis Foundation. https://www.arthritis.org/about-arthritis/types/polymyalgia-rheumatica/. Accessed June 3, 2018.
  6. Buckley L, et al. 2017 American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis & Rheumatology. 2017;69:1521.
  7. Dejaco C, et al. 2015 Recommendations for the management of polymyalgia rheumatica: A European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis & Rheumatology. 2015;67:2569.