Polymyalgia Rheumatica
This week we’ll take a look at a relatively common disorder that affects primarily adults over 50 and can have debilitating effects on a person. Polymyalgia Rheumatica (PMR), is characterized by aching and stiffness in the shoulders, arms, and upper legs that is at its worst in the morning. These symptoms usually occur very quickly, and are not preceded by months of progressive aching or stiffness. PMR is just behind Rheumatoid Arthritis in prevalence of whole-body inflammatory disease, and occurs much more frequently in women than men, with a peak in between age 70-80.
PMR is an impressive diagnosis by its terms, but broken down it means:
Poly - multiple
my (myo) - muscle
algia - pain
Rheumatica - condition associated with pain or inflammation in muscles or joints
In light of simplifying the diagnosis, it is now much easier to understand the disease itself. Many people with PMR come to see their physician because of morning stiffness and pain in their shoulders and hips that improves after about 30 to 60 minutes. After a period of inactivity the stiffness may return once a person starts to move around again. The overnight pain frequently is disruptive of sleep as a person may spend an extended period of time not moving before turning, and this turning will cause a sudden flare of pain, which will wake a person. This can occur frequently throughout the night.
Diagnosis of this disease is difficult. There are some blood tests that can be done to help guide in the right direction, but the most telling is whether or not a person with the symptoms experiences almost complete resolution of those symptoms with steroids (like prednisone). If that occurs, a diagnosis of PMR is very likely.
PMR is an important disease to be aware of as it will cause mobility and function issues, and can mimic other problems like rheumatoid arthritis, fibromyalgia, or other muscle and bone disease but is easily remedied by steroids. Previously mundane tasks, such as walking, getting dressed, and brushing hair may become so arduous that a person needs a caregiver. As this is a disease of primarily older persons, a lot of people will brush off their symptoms as “getting older,” and while that may be true, there is no harm in asking your doctor about this disease if you are experiencing these symptoms.
Key Points:
PMR is a disease of an aging adult that can affect mobility and function
PMR is common, just second to rheumatoid arthritis in whole-body inflammatory disease
Awareness and treatment of this disease can lead to improved mobility, function and independence
