Polymyalgia Rheumatica

What is Polymyalgia Rheumatica?

Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders and hips. Signs and symptoms of polymyalgia rheumatica (pol-e-my-AL-juh rue-MAT-ih-kuh) usually begin quickly and are worse in the morning.

The exact cause of Polymyalgia Rheumatics is unknown, but two factors appear to be involved in the development of this condition:


Certain genes and gene variations might increase your susceptibility.

An environmental exposure

New cases of polymyalgia rheumatica tend to come in cycles, possibly developing seasonally. This suggests that an environmental trigger, such as a virus, might play a role. But no specific virus has been shown to cause polymyalgia rheumatica.

Polymyalgia rheumatica and another disease known as Giant Cell Arteritis share many similarities. Many people who have one of these diseases also have symptoms of the other.

Giant cell arteritis results in inflammation in the lining of the arteries, most often the arteries in the temples. Signs and symptoms include headaches, jaw pain, vision problems and scalp tenderness. If left untreated, this condition can lead to stroke or blindness.

Discussing your medical history and symptoms with a healthcare professional can help you in getting a clear diagnosis. There is no specific test for the condition, and a series of tests will likely need to be done.

Early warning signs that can indicate the need for assessment by doctors include:

Polymyalgia rheumatica (PMR) is a condition that causes pain, stiffness, and inflammation in the muscles around the shoulders, neck and hips.

The main symptom is muscle stiffness in the morning that lasts longer than 45 minutes. It may also cause other symptoms, including:

  • high temperature (fever) and sweating
  • extreme tiredness (fatigue)
  • loss of appetite
  • weight loss
  • depression

If you have pain and stiffness that lasts longer than a week, you should see your GP so the cause can be investigated.

Risk factors for developing the condition include:


Polymyalgia rheumatica affects older adults almost exclusively. It most often occurs between ages 70 and 80.


Women are about two to three times more likely to develop the disorder.


Polymyalgia rheumatica is most common among white people whose ancestors were from Scandinavia or northern Europe.

Aches or pain in your neck, upper arms, buttocks, hips, or thighs are some of the most common symptoms.

If you experience the following, call 911 or visit the emergency room:

  • Severe headache
  • Trouble seeing
  • Balance or coordination problems
  • Weakness or numbness
  • Confusion
  • Trouble speaking

Over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), are not usually recommended for easing the signs and symptoms of Polymyalgia Rheumatica.

Healthy lifestyle choices can help you manage the side effects that corticosteroid treatment can cause:

Eat a healthy diet

Eat a diet of fruits, vegetables, whole grains, and low-fat protein and dairy products. Limit the salt (sodium) in your diet to prevent fluid buildup and high blood pressure.

Exercise regularly

Talk to your doctor about exercise that’s appropriate for you to maintain a healthy weight and to strengthen bones and muscles.

Get enough rest

Rest is necessary for your body to recover from exercise and activities of daily living.

Use assistive devices

Consider using luggage and grocery carts, reaching aids, shower grab bars, and other assistive devices to help make daily tasks easier.

If you have Polymyalgia Rheumatica we recommend you seek this treatment every year. All of these recommended treatments are covered by AHDI in our Standards of Care.

  • Two visits to the doctor a year
  • Two ESR (erythrocyte sedimentation rate) or CRP (c-reactive protein) blood tests a year
  • One Complete Blood Count (CBC) a year

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Rheumatoid Arthritis

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body’s tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

Doctors don’t know what causes Rheumatoid Arthritis or starts this process of your body’s immune system attacking your own healthy tissues, although a genetic component appears likely. While your genes don’t actually cause rheumatoid arthritis, they can make you more likely to react to environmental factors—such as infection with certain viruses and bacteria—that may trigger the disease.

Discussing your medical history and symptoms with a healthcare professional can help you in getting a clear diagnosis. Early treatment is key to avoiding joint damage.

Early warning signs that can indicate the need for assessment by doctors include:

  • Fatigue
  • Slight fever
  • Weight loss
  • Stiffness in joints
  • Joint tenderness
  • Joint pain
  • Joint swelling
  • Joint redness
  • Joint warmth
  • Numbness and tingling in hands and feet
  • Decrease in range of motion
  • Joints affected on both sides of your body

Your sex

Women are more likely than men to develop rheumatoid arthritis.


Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.

Family history

If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.


Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity.

Excess weight

People who are overweight appear to be at a somewhat higher risk of developing rheumatoid arthritis.

The main symptoms of rheumatoid arthritis are joint pain, swelling and stiffness. It may also cause more general symptoms, and inflammation in other parts of the body.

The symptoms of rheumatoid arthritis often develop gradually over several weeks, but some cases can progress quickly over several days.

The symptoms vary from person to person. They may come and go or change over time. You may experience flares when your condition deteriorates, and your symptoms become worse.

Arthritis drugs can cause serious side effects, such as an infusion reaction or a severe infection, that may need emergency treatment. If you experience them, go to the ER or call 911.

Visit urgent care immediately if you are experiencing:

  • High fever with rash
  • Red, hot, swollen joints
  • Severe and sudden abdominal pain
  • A severe, atypical disease flare
  • Sudden spine pain, which may signal a vertebral fracture (Rheumatoid and psoriatic arthritis are risk factors for both osteoporosis and fractures; corticosteroid use raises the risk)

Rheumatoid arthritis doesn’t have a cure, but you can take steps to help manage its symptoms. These steps can help you relieve joint and muscle pain, reduce inflammation, and improve your overall ability to move.

Be physically active

Staying physically active is key to strengthening muscles and keeping joints flexible. It can also protect your joints from further damage. Regular exercise has been found to improve sleep quality, which is especially helpful if your rheumatoid arthritis makes it hard for you to sleep. Ask your physical or occupational therapist to recommend activities that are a good fit for you.

Use heat or cold therapy

Warm baths, showers, heating pads or bags that you heat up in the microwave can help ease pain and stiffness. For symptom flares, it’s usually better to use cold packs to numb pain and reduce inflammation.

Support your joints

Splints can reduce pain and swelling by supporting your joints. Ask your physical or occupational therapist to help you choose and fit the right splint.

Use self-help devices

Zipper pulls, long-handled shoehorns, wheels on carts and suitcases, and other devices to help you get on and off of chairs, toilet seats and beds can reduce stress on your joints.

Take medication

Medications for rheumatoid arthritis can ease symptoms, reduce inflammation and slow the progression of the disease. But it’s best to use medication along with other strategies. Ask your doctor if medication is right for you.

Commit to a healthy lifestyle

Getting enough sleep, avoiding tobacco smoke, using stress-reducing techniques such as meditation, and eating a healthy diet can all help control symptoms of rheumatoid arthritis.

If you have Rheumatoid Arthritis we recommend you see your doctor every year. Recommended treatments are covered by AHDI in our Standards of Care.

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