A common inflammatory condition in older adults, causing pain and stiffness in the shoulders, neck and hips, that usually responds quickly to treatment
Polymyalgia rheumatica, often shortened to PMR, is an inflammatory condition that causes pain and stiffness, particularly around the shoulders, neck and hips. It mainly affects people over the age of 50 and can come on quite suddenly. The good news is that it usually responds well and quickly to treatment.
Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928).
PMR has a fairly recognisable pattern. Typical features include:
It is important to be aware that PMR is sometimes associated with another condition affecting the arteries (giant cell arteritis). New headaches, scalp tenderness, jaw pain on chewing or any change in vision should be assessed urgently.
Diagnosis is based on the characteristic symptoms, an examination and blood tests, which usually show signs of inflammation. Because several other conditions can produce similar symptoms, a careful assessment helps confirm that PMR is the right explanation and excludes other causes.
Ultrasound can help by showing inflammation around the shoulders and hips, supporting the diagnosis. Dr Borukhson uses point-of-care ultrasound during the consultation, so this can often be done in the same visit. You can read more on the ultrasound clinic page.
PMR usually responds promptly to steroid (corticosteroid) treatment, and many people feel substantially better within days of starting. This rapid response to steroids is a defining feature of the condition. The steroid dose is then reduced gradually over time, guided by symptoms and kept under review, as stopping too quickly can allow symptoms to return.
Because treatment continues for a while and is tailored to the individual, regular specialist review helps find the lowest effective dose and monitor progress. The plan is always discussed with you.
PMR is very treatable, and prompt diagnosis can bring quick relief from what can be quite disabling stiffness. Equally important, assessment allows the associated artery condition (GCA) to be considered and acted on quickly if needed. If you have new shoulder and hip stiffness, particularly over the age of 50, a specialist review is worthwhile.
PMR usually responds quickly to treatment. A specialist assessment can confirm the diagnosis and begin relief without delay
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