Polymyalgia rheumatica

Polymyalgia rheumatica
In polymyalgia rheumatica, pain is usually located in the shoulders and hips.
Specialty	Rheumatology
Symptoms	Shoulder, neck and hip pain[1]
Usual onset	Age greater than 50
Diagnostic method	Elevated inflammatory markers, CRP and ESR
Differential diagnosis	Myositis, giant cell arteritis
Medication	Corticosteroids

Polymyalgia rheumatica (PMR) is a systemic inflammatory disease characterized by pain or stiffness, usually in the neck, shoulders, upper arms, and hips, but which may occur all over the body. Almost all cases occur in people age 50 or older. Pain and stiffness of PMR is worst in the morning and improves throughout the day, but these symptoms frequently persist to some extent throughout the day and into the evening.^[2]

People who have polymyalgia rheumatica may also have temporal arteritis (giant cell arteritis), an inflammation of blood vessels in the face which can cause blindness if not treated quickly.^[3] The pain and stiffness can result in a lowered quality of life, and can lead to depression.^[1] The exact cause of PMR, including whether or not it may be an autoimmune disease, is unclear.^[4] Persons of Northern European descent are at greater risk.^[5] There is no definitive laboratory test, but C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can be useful, as non-specific markers of systemic inflammation.^[2]

PMR is usually treated with corticosteroids taken by mouth.^[6] Most people need to continue the corticosteroid treatment for two to three years.^[7] PMR sometimes goes away on its own in a year or two, but medications and self-care measures (e.g., eating the recommended amount of fruits and vegetables) can improve the rate of recovery.^[8]

PMR was first established as a distinct disease in 1966 by a case report^[9] on 11 patients at Mount Sinai Hospital in New York City.^[10] It takes its name from the Greek word Πολυμυαλγία polymyalgia, which means "pain in many muscles".