Polymyalgia rheumatica

Polymyalgia rheumatica, or PMR, involves widespread aching and stiffness.

Symptoms and onset
Polymyalgia rheumatica (PMR) involves widespread aching and stiffness, especially the upper arms, neck, lower back and thighs. This is typically worse in the morning or after inactivity. Joint pain can be involved, as well as disturbed sleep, fatigue, mild fever, general feeling of unwellness (malaise), depression, and loss of appetite and unintended weight loss.

Typically PMR affects adults over 50, with age 70 as average onset. Women are two to three times more likely to develop PMR.

Diagnosis
PMR often (but necessarily) presents with elevated inflammation levels in blood tests, particularly erythrocyte sedimentation rate ("sed rate") and C-reactive protein (CRP). This is one way to differentiate PMR from fibromyalgia; however in some PMR patients, these tests may have normal or only slightly elevated results.

PMR is diagnosed with a trial of low-dose corticosteroids, with the expectation that if the condition is present, symptoms will respond within two to three weeks and sometimes much sooner (even following the first dose).

Treatment
Treatment involves tapering to the lowest comfortable dose of corticosteroids and some patients are able to discontinue within a year although others continued for two to three years and symptoms can recur.

Typically PMR affects adults over 50 with age 70 as average onset.

Studies

 * 1988, "Chronic Epstein-Barr virus infection" syndrome and polymyalgia rheumatica. (Abstract)