Polymyalgia rheumatica
PMR
Autoimmune conditionAn immune-mediated inflammatory condition that causes pain and stiffness in the shoulders, neck, and hips, almost always after age 50.
What happens
Inflammation in and around the shoulder and hip joints causes aching and stiffness that's worst in the morning. It's closely linked to giant cell arteritis, an inflammation of arteries in the head that can threaten vision.
Who gets it
Almost always over 50, most often over 70, and two to three times more common in women.
Common signs
- Aching and stiffness in both shoulders and upper arms
- Hip and thigh stiffness
- Morning stiffness lasting 45 minutes or more
- Trouble getting out of bed or raising your arms
- Fatigue, low-grade fever, or weight loss
Labs to ask about
- ESR and CRP (inflammation markers)
- Complete blood count
- RF and anti-CCP to rule out rheumatoid arthritis
- CK and TSH to rule out muscle and thyroid causes
How it's usually treated
- Low-dose steroids, usually tapered slowly over a year or more
- Steroid-sparing medicines for some people
- Bone protection while taking steroids
Supportive steps to discuss with your provider
- Never stop steroids suddenly.
- Protect your bones with vitamin D, calcium, and weight-bearing activity as advised.
- Stay gently active to keep shoulders and hips mobile.
See a doctor promptly if you have
- A new headache, scalp tenderness, jaw pain when chewing, or vision changes: get same-day care (possible giant cell arteritis)
- Fever or unexplained weight loss
Related conditions
Rheumatoid arthritis
The immune system attacks the lining of the joints, causing painful swelling that can damage cartilage and bone if untreated.
Learn more →Ankylosing spondylitis
An immune-mediated arthritis that mainly affects the spine and the joints where the spine meets the pelvis, causing back pain and stiffness that improve with movement.
Learn more →
Wondering if your symptoms fit a pattern?
Dr. Lesher is a naturopathic doctor who specializes in women's autoimmune and chronic conditions. Since 2020, she has helped more than 900 patients overcome and heal from their conditions.