The medical profession lacks precise knowledge of what causes polymyalgia rheumatica or PMR, although they have linked the disorder to the immune system. PMR affects people over 50 and is most common around age 70, which suggests aging plays a role in its development. This disorder is also more frequent in women and people of northern European heritage. Genetic factors play a role in polymyalgia rheumatica, although research suggests that exposure to some viruses or bacteria may play a role. Corticosteroid treatment can resolve the symptoms of polymyalgia rheumatica quickly. The treatment must continue to keep controlling symptoms, but doctors can usually reduce the dose over time.
Aching shoulder muscles are a telltale symptom of PMR. Studies reveal that 95 percent of people with the disorder experience them, usually on both sides of the body. Many individuals also develop pain and stiffness in the neck, arms, hips, and posterior. Muscles may feel especially stiff and tender after a period of inactivity or prolonged sitting. Stiffness upon arising in the morning affects almost everyone with PMR. In extreme cases, swelling of hands and feet accompany the pain.
Polymyalgia rheumatica causes stiffness that leads to reduced function in the affected limb. It becomes difficult to lift the hand above the head, which interferes with basic activities such as getting dressed and even getting out of bed. Approximately half of the people with PMR experience this symptom, but because it is also symptomatic of other types of arthritis, it can be misdiagnosed initially.
Normally, polymyalgia rheumatica symptoms cause the greatest discomfort in the hour after waking, with some relief returning following light activity. This feature can help doctors differentiate between PMR and other rheumatic conditions, which usually worsen with physical activity.
The suddenness with which polymyalgia rheumatica can develop is another distinguishing feature. It can come on within a few days, or in as little as 24 hours. Some people say the symptoms come on overnight. Some individuals also report vague symptoms such as fatigue, loss of appetite, depression, and weight loss before the muscle and joint stiffness appear.
Polymyalgia rheumatica can make it challenging to get in and out of a car and perform other everyday activities. These symptoms contribute to the tendency for some people with PMR to develop depression. Many conditions lead to symptoms of depression, however, so this symptom alone is not enough to diagnose an individual with PMR.
While doctors lack a comprehensive understanding of the nature of PMR, they can isolate factors that lead to flare-ups. Stiffness in the shoulders, neck, and pelvis often follows long periods of inactivity, such as sleeping. PMR is generally worse in the morning because the individual has been lying down and inactive for so many hours. A lengthy car ride or hours sitting in front of a computer monitor may have a similar effect.
Fatigue is another PMR symptom that does not help in diagnosis but is felt by many people with the disorder. People with polymyalgia rheumatica often have difficulty getting to sleep, which begins to interfere with sleep quality. This can lead to fatigue during the day. Some individuals may also be reluctant to rest or go to bed because they know their symptoms will be more severe when they wake up.
Many conditions can cause unexpected and unintended weight loss, and polymyalgia rheumatica is no exception. Various factors lead to weight loss in people with diseases and disorders, but the most common cause in people with PMR is decreased food intake due to loss of appetite. If a person with PMR also has depression, this may contribute to their lack of appetite.
The first stages of polymyalgia rheumatica are often accompanied by fever. This, in addition to the other flu-like symptoms people can develop early on, explains why many with the condition initially assume they have the flu. Body temperature can rise as high as 100 degrees F but rarely progresses to a high-grade fever. The moderate level of the fever helps doctors rule out other potential causes, once they consider other symptoms.
Anemia is another common symptom that is caused by a wide range of medical conditions, including polymyalgia rheumatica. It describes a lack of red blood cells or hemoglobin in the body and can cause additional symptoms such as shortness of breath and dizziness. Anemia in people with PMR is usually mild.
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