What is polymyalgia rheumatica?

Polymyalgia rheumatica means 'pain in many muscles'. It is a condition inflammation in your joints and the tissues around your joints causes your muscles to feel painful and stiff. The muscles in the shoulders, neck and hips are commonly affected.

Polymyalgia rheumatica usually affects older adults.

However, when treated, your symptoms can improve rapidly and may eventually disappear altogether.

What causes polymyalgia rheumatica?

The exact cause of polymyalgia rheumatica is not known. It's thought that genetics and some environmental factors, such as certain infections, play a role. Research is ongoing.

What are the symptoms of polymyalgia rheumatica?

Polymyalgia rheumatica can cause:

• pain and stiffness in your shoulders, neck, buttocks and thighs; on both sides of your body
• pain that is worse in the morning or after not moving for a while, for example, after a long car ride or sitting for a long time
• difficulty with daily activities, such as lifting your arms up to put clothes on, bending over to put on shoes or getting up from a low chair

You might also have other symptoms such as:

• feeling generally unwell
• mild fever
• weight loss
• difficulty sleeping
• fatigue

Each person experiences polymyalgia rheumatica differently. Symptoms can develop quickly or take a few days or weeks. They may be mild or severe.

If you are concerned about any of these symptoms, see your doctor.

How is polymyalgia rheumatica diagnosed?

There is no single test available used to diagnose polymyalgia rheumatica. Symptoms can be similar to other types of arthritis, so it can take time for your doctor to confirm the diagnosis.

Your doctor can diagnose you with polymyalgia rheumatica by:

• asking you about your symptoms
• examining you
• referring you for blood tests to check for signs of inflammation — for example, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)

You might still have polymyalgia rheumatica even if your blood test results are within the healthy range.

Your doctor may refer you to a rheumatologist (joint and muscle specialist).

How is polymyalgia rheumatica treated?

Polymyalgia rheumatica is treated with corticosteroid medicines.

You may need to start on a high dose to control your symptoms. Once your symptoms are under control, your doctor may advise you to gradually reduce your dosage to the lowest dose that keeps you symptom-free.

You may find that your symptoms improve quickly — even after just a few days of starting your treatment. However, it can take from several months to up to 3 years for the condition to completely settle. For this reason, it's usually recommended to continue treatment for 1 to 2 years.

Some people develop unwanted side effects from corticosteroids. See your doctor if you experience side effects, as there may be things you can do to relieve them. Your doctor might recommend also calcium and vitamin D supplements or other medicines to treat certain side effects.

You may also be able to limit your symptoms by:

• eating a healthy diet — This can help you have better energy levels, feel better within yourself and achieve a healthy weight.
• exercising regularly — Low-impact activities such as swimming or walking can reduce your muscle pain and stiffness.
• learning new ways to manage your pain — Try different techniques until you find some that work for you. For example, heat packs help reduce muscle pain and cold packs can help reduce inflammation.

For some people, polymyalgia rheumatica goes away with treatment and doesn't come back. For others, polymyalgia rheumatica affects them for life.

Complications of polymyalgia rheumatica

Polymyalgia rheumatica, increases your risk of developing a serious illness called giant cell arteritis. This is a condition where the body attacks your own blood vessels. It mainly affects the heart and smaller blood vessels on the sides of the head.

Symptoms of giant cell arteritis include:

• severe headache
• blurred or double vision
• pain in your jaw when you chew
• soreness and tenderness in one temple (side of the forehead)

If giant cell arteritis is not treated quickly, it can lead to blindness.

If you are worried you may have giant cell arteritis, you should see your doctor or visit a hospital emergency department within 24 hours.

Another complication of polymyalgia rheumatica is depression. Depression is especially common in people who have ongoing symptoms.

Resources and support

• Arthritis Australia offers a range of information and support services to help you better understand and manage your health.
• Musculoskeletal Health Australia have has information about polymyalgia rheumatica.
• If you or a loved one is suffering from pain, Pain Australia has a National Pain Services directory that can help you find services right for you.