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What is PMR?

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It is an autoimmune condition affecting individuals with over 50 years of age that causes inflammation of proximal large joints such as shoulders, hips as well as tendons around those joints leading to sudden onset, marked pain and morning stiffness (lasting at least 1 hr) in the affected joints. 

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What are the symptoms?

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Symptoms include dramatic onset of significant pain and stiffness in and around shoulders, neck, upper arms, hips, buttocks, lower back and thighs. It can severe enough for some people to not able to get out of bed in the morning or able to lift shoulders overhead. Sometimes it also causes pain, swelling and stiffness of hands and wrist joints, just like rheumatoid arthritis. 

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In a minority of cases, occurrence of temporal headache, new vision change, double vision, jaw pain while chewing or unexplained fever, new night sweats or weight loss can indicate simultaneous presence of a more serious condition called Giant cell arteritis. 

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How is it diagnosed?

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Typical symptoms as described above along with high blood inflammation markers are used to make a diagnosis. 

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How is it treated?

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Typical treatment includes use of oral steroids and in some cases DMARDs (disease modifying anti rheumatic drugs) such as methotrexate can be used. Recently, an injectable biologic medication has been approved by FDA to be used for this condition. 

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Mostly all the patients do very well with the treatment. However, long term use of steroids should be managed by a specialist to monitor for steroid related adverse effects.