If you suffer from pain and stiffness – without swollen joints – in certain areas of the upper body, you may be suffering from a condition known as polymyalgia rheumatica (PMR). This fairly common condition generally does not present in younger people. In fact, the average age for symptom onset is 70.
PMR is an age-related disease with no apparent cause. It doesn’t appear to develop as a side effect of medication. It also doesn’t appear to be directly related to any particular form of injury. PMR could be triggered by some sort of infection, but medical science has not definitively proven that yet.
You might find PMR easier to understand if we break down the words. The term ‘myalgia’ is related to the Greek word describing muscle pain. The ‘poly’ prefix implies involvement of several areas and ‘rheumatic’ refers to pain in the joints, muscles, or fibrous tissues.
Common Symptoms of PMR
PMR’s primary symptom is muscle stiffness in the upper arms and shoulder girdle. Stiffness is at its worst during the morning hours; it generally lasts for about 45 minutes or so. Aching and stiffness are most commonly observed in the lower back, thighs, neck, shoulder girdle and upper arms. Blood tests are carried out if I am suspecting PMR and these often show raised inflammation markers which would be consistent with the diagnosis.
In addition to pain and stiffness, many PMR patients also report:
- loss of appetite
- weight loss
- extreme fatigue.
The pain and stiffness from PMR can be distracting enough that patients are not hungry during the morning hours. Thus, they lose their appetites and do not eat as much as they should, which explains the weight loss associated with the condition. As for the extreme fatigue, it is a fairly common symptom of rheumatic diseases.
The body expends a lot of energy dealing with pain. Consequently, chronic pain can lead to fatigue. Note that there is one more symptom we rheumatology specialists observe from time to time: depression. Rheumatic conditions are known to lead to depression in some patients because the pain and fatigue are overwhelming.
PMR Can Be Treated
I consider myself among the top private rheumatologists in London. During my years of practice, I have consulted with countless patients suffering from PMR. I can tell you that the condition is treatable. Because it does not present with joint inflammation, it can be difficult to diagnose. So you need a rheumatology specialist who recognises the symptoms and knows how to treat it.
PMR responds very well to corticosteroids. One medication we use here in the UK is prednisolone. Patients are typically prescribed a moderate dose that is gradually reduced over time. Though patients can begin feeling better in just a few days, a rheumatologist can treat for up to two years to keep symptoms from returning.
You should know that NSAIDs like ibuprofen and naproxen are not effective in relieving the pain of PMR. Therefore, if you have been exhibiting the classic symptoms of the condition and found no relief from NSAIDs, there is a good chance that PMR is at the root of your problem.
Let’s Talk About Your Symptoms
As a private rheumatologist, PMR is a condition I am very familiar with. I invite you to contact my London office to set up an appointment. Let us meet and talk about your symptoms in detail. If you are suffering from PMR, we can get a treatment programme started right away. The sooner treatment begins, the sooner you will start to feel better.
PMR can be a chronic and debilitating condition. It doesn’t have to be. It is routinely diagnosed by experienced rheumatologists and treated effectively with corticosteroids.
Getting help for Polymyalgia Rheumatica
It is vital to get the correct diagnosis and treatment for polymyalgia rheumatica (PR), so you can rule out any other potential cause for your pain symptoms. Once other conditions are ruled out, you can start on the proper treatment that will help you manage your condition.
Because as yet there are no definitive tests for PR, it is a simple process of elimination. But you will be tested for inflammatory markers and have all the same lab tests, scans and physical examinations to help with your diagnosis.
We know from previous experience of treating PR that corticosteroids are an effective part of pain management. Most patients treated with corticosteroids start to feel better quite quickly – usually within two or three days.
Managing Polymyalgia Rheumatica
Alongside your medical treatment for PR, there are many things you can do to help manage your symptoms at home. Self-help measures include getting plenty of fresh air and sunshine to help naturally top up your vitamin D levels.
Eating a protein and calcium-rich diet is also recommended to help keep your bones and muscles strong. Avoid inflammatory foods such as sugar, grains and industrial seed oils (sunflower, safflower, rapeseed, flaxseed etc.).
Eat plenty of protein and calcium-rich foods at each meal, including chicken, sardines, cheese and full-fat natural Greek yoghurt with no added sugar.
Staying physically active with regular gentle exercise is also recommended. Try walking, swimming, tai-chi and yoga to help keep muscles and joints strong and flexible.
What is the Difference Between Fibromyalgia and Polymyalgia?
Many people wonder what the difference is between fibromyalgia and polymyalgia. The names sound so similar, and both conditions share some common symptoms.
‘Myalgia’ is the name for pain experienced within the muscles, and both fibromyalgia and polymyalgia share muscle pain symptoms. However, these conditions differ in other aspects.
Polymyalgia is an inflammatory disease of muscle. The exact cause is still unknown to science, but it is considered an autoimmune disease where the body’s own immune system attacks the connective tissues within the body.
Fibromyalgia is not an inflammatory condition. It is caused by issues with sensory processing within the central nervous system. With fibromyalgia, you tend to experience pain all over your body rather than in just one specific area.
What does polymyalgia pain feel like?
Those diagnosed with polymyalgia will usually experience severe pain and stiffness in the neck, shoulders and hips. Other things experienced include flu-like symptoms such as running a fever and a general feeling of weakness.
Polymyalgia and fibromyalgia tend to be more common in women than men, and these diseases can strike at any age. However, polymyalgia is quite rare in those aged under 50.
Polymyalgia rheumatica specialist near me
Dr Bhadauria is a consultant rheumatologist that specialises in the diagnosis and treatment of many conditions that affect the muscles and joints of the body, including fibromyalgia and polymyalgia rheumatica.
The treatment approaches differ between fibromyalgia and polymyalgia, so you must get a proper diagnosis for your condition to receive the appropriate treatment.
Article by Dr. Naveen Bhadauria