Polymyalgia rheumatica (PMR)

Overview

Polymyalgia rheumatica (PMR) is a chronic inflammatory disorder that causes widespread pain and stiffness in the muscles, particularly in the shoulders and hips. It is a common condition that affects older adults, with the majority of cases occurring in people over the age of 65. PMR is often accompanied by giant cell arteritis, a condition that causes inflammation of the blood vessels, which can lead to headaches, vision difficulties, jaw pain, and scalp tenderness.

Types of Polymyalgia rheumatica (PMR)

There are no subtypes of PMR, but the condition can be classified based on the severity of symptoms and the presence of other conditions. The most common classification system used is the Newcastle criteria, which categorizes PMR into three stages:

1. Stage I: Mild symptoms, with pain and stiffness in the muscles that are not severe enough to interfere with daily activities.
2. Stage II: Moderate symptoms, with pain and stiffness that are significant enough to interfere with daily activities but not severe enough to require hospitalization.
3. Stage III: Severe symptoms, with pain and stiffness that are severe enough to require hospitalization or cause significant disability.

Causes of Polymyalgia rheumatica (PMR)

The exact cause of PMR is unknown, but it is believed to be related to an abnormal immune response. The condition is thought to occur when the immune system mistakenly targets healthy tissues, leading to inflammation and pain.

Risk Factors of Polymyalgia rheumatica (PMR)

The following risk factors may increase the likelihood of developing PMR:

1. Age: The majority of cases occur in people over the age of 65.
2. Family history: A family history of PMR may increase the risk of developing the condition.
3. Other medical conditions: Certain medical conditions, such as giant cell arteritis, may increase the risk of developing PMR.
4. Genetic factors: Genetic factors may play a role in the development of PMR.

Symptoms of Polymyalgia rheumatica (PMR)

Preventions of Polymyalgia rheumatica (PMR)

There is no known way to prevent PMR, but early diagnosis and treatment can help manage symptoms and reduce the risk of complications.

Diagnosis of Polymyalgia rheumatica (PMR)

The diagnosis of PMR is typically made based on a combination of medical history, physical examination, and laboratory tests. The following tests may be used to diagnose PMR:

1. Physical examination: A physical examination will be performed to assess muscle strength, range of motion, and joint function.
2. Laboratory tests: Laboratory tests may be used to rule out other conditions that may be causing symptoms. These tests may include:
   • Complete blood count (CBC)
   • Erythrocyte sedimentation rate (ESR)
   • C-reactive protein (CRP)
   • Rheumatoid factor (RF)
   • Anti-citrullinated protein antibody (anti-CCP).

Treatment for Polymyalgia rheumatica (PMR)

The treatment and management of PMR typically involve a combination of medications and lifestyle changes. The following medications may be used to treat PMR:

1. Corticosteroids: Corticosteroids are commonly used to treat PMR due to their anti-inflammatory effects.
2. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs may be used to treat mild symptoms of PMR.
3. Disease-modifying antirheumatic drugs (DMARDs): DMARDs may be used to treat more severe symptoms of PMR.

Lifestyle changes that may help manage symptoms include:

1. Rest: Resting and avoiding strenuous activities can help reduce symptoms.
2. Exercise: Gentle exercise, such as yoga or stretching, may help improve flexibility and reduce symptoms.
3. Heat or cold therapy: Applying heat or cold therapy to affected areas may help reduce pain and stiffness.
4. Assistive devices: Using assistive devices, such as walkers or canes, may help improve mobility and reduce symptoms.

When to seek medical attention ?

If you experience any of the following symptoms, you should seek medical attention:

1. Severe pain: Severe pain that interferes with daily activities.
2. Morning stiffness: Morning stiffness that lasts for more than 30 minutes.
3. Fatigue: Fatigue that persists despite rest and relaxation.
4. Weight loss: Weight loss due to reduced appetite or difficulty eating due to muscle stiffness.