Polymyalgia Rheumatica (PMR)
About the disease & condition
Known Symptoms
- Classic symptoms: Bilateral shoulder and hip girdle pain and stiffness. Morning stiffness lasting >30 minutes. Acute onset of symptoms (days to weeks).
- Systemic symptoms:
Fatigue, low-grade fever, weight loss, malaise. - Red flags: Headache, jaw claudication, visual changes (suggestive of concomitant giant cell arteritis). Asymmetric symptoms or peripheral arthritis (may indicate other diagnoses).
Known Causes
- Etiology: Unknown, but believed to involve genetic predisposition (e.g., HLA-DR4) and environmental triggers (e.g., infections). More common in women and individuals of Northern European descent.
- Pathophysiology: Systemic inflammation mediated by cytokines (e.g., IL-6) leading to synovitis and bursitis of proximal joints. Possible link to immune system dysregulation and age-related changes.
Care
- Prevention: No known preventive measures; early diagnosis and treatment reduce complications.
- Follow-up: Regular monitoring for symptoms of GCA (e.g., headache, visual changes).
Bone density monitoring if on long-term steroids. Patient education on steroid side effects and taper adherence.
Note: PMR is a clinical diagnosis supported by labs and response to steroids. It is crucial to rule out GCA due to the risk of permanent vision loss. Collaboration with rheumatology is recommended for complex cases or suspected GCA. Most patients achieve remission, but relapses may require prolonged treatment.
Relevant Specialties
Rheumatology
The Rheumatology & Clinical Immunology team at our diagnoses and treats disorders that arise when the immune system mistakenly attacks the body. These conditions can affect joints, muscles, skin and internal organs. Our specialists diagnose and combine clinical assessment with imaging, blood tests for autoantibodies and, where needed, tissue sampling, so treatment is based on clear evidence. Procdures are multidisciplinary: rheumatologists and clinical immunologists work closely with physiotherapists, pain specialists, surgeons, obstetricians and paediatric teams to create personalised plans for each patient. Treatment options range from conventional and biologic disease-modifying drugs to joint aspiration and targeted injections, alongside physiotherapy, bone-health management and supervised daycare infusions when required.
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