Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis
Polymyalgia rheumatica (PMR) is a type of inflammation that produces pain and stiffness in the muscles around the neck, shoulders, buttocks, hips, and thighs. It seldom occurs in individuals younger than 50 years. No one knows what causes the inflammation in PMR, but it is not an infectious illness (like colds). Therefore you cannot “catch” it from another individual. Polymyalgia rheumatica is diagnosed mostly by its symptoms. However, most individuals with PMR have evidence of inflammation as indicated by the results of two blood tests: the erythrocyte sedimentation rate (ESR) and the C-reactive protein (CRP). Because there are other diseases that can cause symptoms similar to those of PMR, your doctor will probably order other blood tests to be sure you do not have another problem.

Living With Your Diagnosis
Individuals with PMR commonly notice pain and stiffness (a feeling of restricted motion) in the muscles around the neck, shoulders, buttocks, hips, and thighs. The pain and stiffness are most noticeable in the morning and may improve with activity during the course of the day. Occasionally, PMR may also cause pain and swelling in the joints. In addition, PMR can also cause fatigue, poor appetite, fever, and sweats. Approximately 20% of individuals with PMR also have another condition called “temporal arteritis,” which may cause headaches and sudden vision changes. Your doctor will determine whether you also have this condition. Fortunately, the treatment of PMR results in considerable improvement in nearly all of these symptoms within a few days. Although PMR responds to therapy, some patients may require treatment for more than 2 or 3 years.

The most common treatment for PMR is corticosteroids (cortisone-like medicines such as prednisone). Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are sometimes also used. Potential side effects of corticosteroids are increased appetite, weight gain, difficulty sleeping, easy bruising, and stomach upset. Longer term use of corticosteroids can lower your resistance to infection, and cause stomach ulcers and bone thinning (osteoporosis). Corticosteroids should always be taken with food to prevent stomach upset. In addition, patients should receive adequate amounts of calcium and vitamin D to help prevent osteoporosis.

The DOs
• Take your medicines as prescribed.
• Ask your doctor which over-the-counter medications you may take with your prescription medications.
• Inform your doctor and dentist that you are taking a corticosteroid (prednisone).
• Eat a well-balanced diet low in carbohydrates and fat to prevent excessive weight gain.
• Perform a physician-prescribed weight-bearing exercise program.

The DON’Ts
• Wait to see whether side effects from the medicines will go away.
• Stop taking the corticosteroid medicine unless your physician instructs you to do so.
• Overeat, because corticosteroids may increase your appetite.
• Continue an exercise program that causes pain.

When to Call Your Doctor
• You have any medication side effects.
• Your pain and/or stiffness return during treatment.
• You have new headaches, cramping in your tongue or jaw, or sudden changes in your vision.
• You run out of prednisone (cortisone).