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Polymyalgia rheumatica (meaning “pain in many muscles” in Greek), abbreviated as PMR, is an inflammatory condition of the muscles, which causes pain or stiffness, usually in the neck, shoulders, and hips. The pain can be very sudden, or can occur gradually over a period of time.
Most PMR sufferers wake up in the morning with pain in their muscles; however, there have been cases in which the patient has developed the pain during the evenings.[1] Patients who have polymyalgia rheumatica may also have temporal arteritis, which causes inflammation that damages large and medium size arteries. PMR usually goes away within a year or two after treatment.[2]
There is a wide range of symptoms that indicate if a person has polymyalgia rheumatica. The symptoms include pain and stiffness in the muscles, usually in the neck, shoulders, and hips. The pain is moderate to severe, and may inhibit the activity of the person. These symptoms usually occur in the morning, or after sleeping. Fatigue and lack of appetite are also indicative of polymyalgia rheumatica. Lack of appetite could lead to unintentional weight loss. Anemia is another sign of polymyalgia rheumatica. An overall feeling of illness and a slight fever are commonly seen.[2]
Studies have shown that about 15% of people who are diagnosed with polymyalgia rheumatica also have temporal arteritis, and about 50% of people with temporal arteritis have polymyalgia rheumatica. Some symptoms of temporal arteritis include severe headaches, scalp tenderness, jaw or facial soreness, distorted vision or aching in the limbs caused by decreased blood flow, and fatigue.[1]
The cause of this disorder is unknown; and during this disorder, the white blood cells in the body attack the lining of the joints, causing inflammation.[2] Recent studies have found that inherited factors also play a role in the probability that an individual will become sick with polymyalgia rheumatica. Several theories have included viral stimulation of the immune system in genetically susceptible individuals.[3] Several viruses are thought to be linked to polymyalgia rheumatica, including the adenovirus, which causes respiratory infections; the human parvovirus B19, an infection that affects children; and the human parainfluenza virus.[2]
There is no specific test to diagnose polymyalgia rheumatica. There are many other diseases which cause inflammation and pain in muscles, but there are a few tests that can help narrow down the cause of the pain. Limitation in shoulder motion, or swelling of the joints in the wrists or hands are noted by the doctor.[3] The doctor will assess the patient’s pain, and may perform one of the following tests to determine if polymyalgia rheumatica is indeed the cause of the pain.[2]
One blood test that is usually performed is the erythrocyte sedimentation rate (ESR) which measures how fast the patient’s red blood cells settle in a test tube. The faster the blood cells settle, the higher the ESR value, which means that there is inflammation. Many conditions can cause an elevated ESR, so this test alone is not proof that a person has polymyalgia rheumatica.[2]
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