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Polymyalgia Rheumatica

Inflammatory rheumatic disease with stiffness and pain in the shoulder and hip girdles.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Polymyalgia Rheumatica?

Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease of people over 50 characterised by symmetric pain in the shoulder and pelvic girdle, prolonged morning stiffness and elevated acute-phase reactants. It is 2-3 times more common in women and has a higher incidence in northern European populations.

The exact pathogenesis is unclear; genetic predisposition (HLA-DRB1*04), cytokine dysregulation and periarticular/bursal inflammation contribute. PMR is closely linked to giant-cell arteritis: about 15-20% of PMR patients have coexistent temporal arteritis.

Diagnosis rests on the clinical picture (age, typical pattern, raised acute-phase markers) and a dramatic response to low-dose prednisolone. Subacromial and subdeltoid bursitis and bicipital tenosynovitis are characteristic on ultrasound. Treatment usually lasts 1-2 years.

Symptoms

Symmetric shoulder and hip-girdle pain
Severe morning stiffness (>45 minutes)
Difficulty raising the arms
Inability to roll over in bed or get up from a chair
Malaise and low-grade fever
Weight loss and loss of appetite
Depression and sleep disturbance
Symptoms of giant-cell arteritis (headache, visual loss)

Risk Factors

Age over 50 (most common 70-80)
Female sex
Northern European descent
HLA-DRB1*04 positivity
History of giant-cell arteritis
Family history of PMR
Seasonal variation (spring–autumn)
Possible infectious triggers

When to See a Doctor?

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

  • Sudden onset of shoulder and hip pain in someone over 50
  • Severe morning stiffness
  • Reduced range of movement that affects self-care
  • Raised ESR and CRP
  • Features that raise suspicion of giant-cell arteritis
  • Persistent symptoms despite treatment

Treatment Methods

01
Low-dose oral prednisolone (12.5-25 mg/day) as cornerstone therapy
02
Gradual dose taper over months
03
Methotrexate as a steroid-sparing agent in selected cases
04
High-dose steroid if giant-cell arteritis is present
05
Calcium and vitamin D supplementation
06
Bisphosphonate prophylaxis for osteoporosis
07
Tocilizumab in resistant or relapsing disease

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.