Aching and Stiffness in the Elderly - Could it Be Polymyalgia Rheumatica (PMR)?

Polymyalgia Rheumatica or PMR is a common disorder in the elderly that causes moderate to severe aching and stiffness in the neck, shoulders, upper arms, hips and thighs, especially at night and first thing in the morning.

What Causes Polymyalgia Rheumatica (PMR)?

The cause of Polymyalgia (PMR) has not yet been determined. It seldom appears in people under 50 years old, and is most common in those over 65, so is considered a condition associated with aging. Other factors may include genetic predisposition, environment or infection. No connection to drug side effects has been found.

What Will I Experience If I Have Polymyalgia Rheumatica (PMR)?

Polymyalgia Rheumatica (PMR) can come on gradually, or very quickly over just a day or two. Typically the pain and stiffness are worse at night and upon first getting up in the morning or after prolonged periods of inactivity.

A PMR sufferer may experience severe aching and stiffness in the neck, shoulders, upper arms, hips and upper thighs and he may feel very weak or tired. According to the Mayo Clinic: "In addition to the musculoskeletal stiffness ... people with polymyalgia rheumatica also may have flu-like symptoms, including fever, weakness, and weight loss."

Is Polymyalgia as Serious as Fibromyalgia?

Every individual will experience the pain from Polymyalgia and Fibromyalgia differently, so it's hard to say if your Polymyalgia pain might be more or less severe than another individual's Fibromyalgia pain.

However, unlike Fibromyalgia, Polymyalgia Rheumatica is highly treatable, symptoms can usually be eased or controlled within a few days of treatment and the condition resolved within one to a few years at the outside. Relapse may, however, occur in approximately 25-50% of patients, in which case treatment may have to be repeated.

Can Polymyalgia Rheumatica (PMR) Be Prevented?

Since the cause of PMR is not known, there is no known way to prevent it. Good nutrition and regular exercise are always advisable, but are no guarantee of preventing the ailment.

How Is Polymyalgia Rheumatica (PMR) Diagnosed?

If you think you may have PMR, go to your physician as soon as possible.

While you may not have any outward signs of a rheumatic disorder such as swelling, your doctor will be able to do a blood test to check for inflammation which is often present with Polymyalgia, either using what is called the erythrocyte sedimentation rate ("SED-rate") test or the C-reactive Protein (CRP) test or both.

Can Polymyalgia Rheumatica (PMR) Be Treated or Cured?

Yes - Treatment for PMR is highly successful.

To treat your Polymyalgia, your doctor will likely put you on a corticosteroid such as prednisone. The stiffness and discomfort from the PMR should be greatly lessened or controlled within a few days and you can return to normal activities.

Your doctor will then want to monitor your SED-rate or CRP levels frequently, keeping your corticosteroid dose as low as possible to control symptoms, then reducing it altogether over time. The condition can usually be successfully treated and the treatment discontinued in six months to one to two years. Again, if it reoccurs, return to your doctor immediately to resume treatment until it is gone.

Resources:

American College of Rheumatology: http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/polymyalgiarheumatica.asp

Mayo Clinic: http://www.mayoclinic.com/health/polymyalgia-rheumatica/DS00441

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): http://www.niams.nih.gov/Health_Info/Polymyalgia/default.asp

Vasculitis Foundation: http://www.vasculitisfoundation.org/polymyalgiarheumatica