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Polymyalgia Rheumatica Polymyalgia Rheumatica, also known as “PMR”, is a common cause of widespread aching and stiffness primarily in the shoulder and hip joints. PMR usually occurs in individuals over 50 and tends to be more common in women than men. Onset of symptoms are usually gradual over the course of a few days to weeks, but may also occur overnight.  Pain usually occurs on both sides of the body and is worse in the morning but gets better throughout the day. Inactivity or prolonged postures tend to reproduce stiffness causing sleep disturbances, and trouble with overhead activities/dressing.

Symptoms
 
  • Pain and stiffness in the shoulders and/or neck that usually progresses to the hips.
  • Anemia
  • Loss of appetite leading to weight loss
  • Depression
  • Fever
 
Causes
 
PMR presents insidiously with no known cause. New research suggests that the pain associated with the upper arms and thighs results from referral from inflammation occurring at the pathologic joints themselves along with their associated bursae. PMR is usually diagnosed by blood tests that yield abnormally high levels of CRP or erythrocyte sedimentation rates.
 
Treatment
 
Corticosteroids, such as prednisone (ie. Deltasone, Orasone), are the primary treatment prescribed by physicians in 10-15 mg dosages to alleviate stiffness, but there is currently no cure for PMR. As symptoms subside in response to corticosteroid therapy, the MD will gradually decrease dosage until a lower, comfortable dosage is reached. Steroidal treatment can last anywhere from 1-3 years depending on the patient’s response. Side effects include increases in blood sugar, sleeplessness, osteoporosis, cataracts, and bruising. Responses to corticosteroid therapy vary, but if no positive response is seen after 3 weeks, the MD may consider a different diagnosis. NSAIDs (ie Ibuprofen and Naproxen), are ineffective against PMR.
 
References
https://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Polymyalgia_Rheumatica/
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001452/#adam_000415.disease.treatment
http://www.primehealthchannel.com/wp-content/uploads/2010/12/Polymyalgia-Rheumatica.jpg
 
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Article produced by: Lujaye Ramirez, SPT