As you get older, a little ache here and a little pain there can become a little annoying.
But sometimes it's more than annoying. Aches and pains that interfere with daily activities may make you wonder if something is wrong. One relatively common cause of aches and pains in older adults is a form of arthritis called polymyalgia rheumatica (PMR).
Symptoms and risk factors
PMR causes muscle pain or stiffness primarily in the upper arms, shoulders, neck, hips and thighs. The level of pain can range from moderate to severe.
The disease can be difficult to diagnose because it rarely causes visible symptoms, such as swollen joints. According to the American College of Rheumatology (ACR) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), some key markers of PMR can include:
- Pain that makes it difficult to raise the arms above the shoulders.
- Pain that is worse in the morning or after inactivity.
- Flu-like symptoms such as fever, weakness or weight loss.
- Symptoms that develop quickly, sometimes overnight.
PMR usually appears in people older than 50 and occurs more often in women than in men, according to NIAMS. People who are white are also more at risk, but a person of any race can develop PMR.
The cause of PMR is not known. Researchers continue to study the role of heredity, immune system issues and environmental influences. Current evidence suggests that PMR is a type of arthritis that specifically targets the shoulder and hip joints, and the bursae, or sacs, around these joints.
Diagnosis and treatment
A physical exam, medical history, symptoms and blood tests to check for inflammation are all used to help diagnose PMR.
If PMR is suspected, treatment usually starts with a low dose of prednisone, a corticosteroid used to treat inflammation. The dose is gradually increased until symptoms are controlled. Nonsteroidal anti-inflammatory drugs (NSAIDs) are not effective in the initial treatment of PMR (though they may be helpful after prednisone treatment ends).
PMR symptoms will respond quickly to prednisone, according to the ACR. Some people feel better after one dose. If symptoms aren't relieved within two to three weeks, your doctor will probably reconsider your diagnosis and start checking for other possible causes of your symptoms.
There are risks associated with taking prednisone. You may need additional medication to prevent side effects, which may include osteoporosis, high blood pressure and cataracts.
Some less severe side effects of taking prednisone may include weight gain, upset stomach, trouble sleeping and mood swings.
These side effects typically get better when you stop taking the medicine.
Prednisone is a strong medication, so it's important to take it as directed. Don't discontinue medication or lower your dose without talking with your doctor first. Tell your doctor if you experience any side effects.
PMR can sometimes be associated with another, more serious condition called giant cell arteritis, an inflammation of the arteries in the temple. If not treated, giant cell arteritis can cause blindness.
Symptoms of giant cell arteritis include headache, changes in vision and pain in the jaw. You should call your doctor right away if you experience these symptoms. Like PMR, giant cell arteritis can be successfully treated with prednisone.
The long-term outlook
Once symptoms are under control, your doctor will gradually decrease your dose of prednisone to the lowest level that eases symptoms.
You'll probably need to continue to take a lower dose of prednisone for one to two years—some people need to take it for up to three years. Sometimes symptoms return after medication is stopped. NIAMS says that if symptoms of PMR recur, you'll need medication again.
Reviewed 10/24/2023