Polymyalgia Rheumatica: Symptoms, Treatment, and How to Find Relief
- Dr. Waleed Bolad
- 10 hours ago
- 7 min read
Polymyalgia rheumatica (PMR) is one of the most common inflammatory conditions affecting adults over 50, yet it remains widely misunderstood and frequently misdiagnosed.
At Bolad Clinic, we specialise in diagnosing and treating PMR with compassionate, evidence-based care, helping patients reclaim their mobility and quality of life.
In this guide, we cover everything you need to know about polymyalgia rheumatica symptoms, causes, diagnosis, and the most effective polymyalgia rheumatica treatments available today.
What Is Polymyalgia Rheumatica?
Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders, neck, upper arms, hips, and thighs. The word "polymyalgia" literally means "pain in many muscles." While the exact cause is not fully understood, it is believed to involve an abnormal immune response that triggers widespread inflammation.
PMR almost exclusively affects adults over 50 years old and is roughly twice as common in women as in men. It is closely associated with giant cell arteritis (GCA), a related condition involving inflammation of blood vessels that can affect vision.
Polymyalgia Rheumatica Symptoms: What to Watch For.
Recognising PMR symptoms early is critical to preventing long-term complications. PMR symptoms typically come on relatively quickly, sometimes within days or weeks and are often worse in the morning or after periods of inactivity.
Common symptoms include:
Aching and stiffness in the shoulders, upper arms, neck, and hips
Stiffness that is worse in the morning and tends to improve as the day progresses
Difficulty with everyday tasks such as raising your arms above your head, getting dressed, or standing from a seated position
Fatigue and a general feeling of being unwell
Mild fever and unintentional weight loss in some cases
Depression or low mood due to chronic pain and reduced mobility
Why Are PMR Symptoms Worse in the Morning?
A hallmark feature of PMR is that symptoms are significantly worse in the morning. This is because inflammatory chemicals accumulate around the joints and muscles during periods of rest. Many patients report that morning stiffness lasts 45 minutes or more, which is a key indicator that distinguishes PMR from other musculoskeletal conditions. Symptoms typically improve as you move throughout the day, though they may never fully resolve without treatment.
Warning Sign — PMR and Vision Loss
Important: PMR is associated with giant cell arteritis (GCA), which can in some cases lead to sudden vision loss or visual disturbances. If you experience any changes in your vision alongside PMR symptoms including blurring, double vision, or visual loss in one or both eyes seek emergency medical attention immediately.
Early treatment with high-dose corticosteroids can prevent permanent visual impairment.
What Causes Polymyalgia Rheumatica? Risk Factors Explained
The exact cause of polymyalgia rheumatica is not yet fully understood. Researchers believe it results from a combination of genetic predisposition and environmental triggers particularly certain viral infections that cause the immune system to malfunction and attack healthy tissue.
Known risk factors include:
Age: PMR almost exclusively affects people aged 50 and over, with the average age of diagnosis around 70.
Sex: Women are approximately twice as likely as men to develop PMR.
Ethnicity: PMR is most common in people of Northern European or Scandinavian descent.
Family history: A genetic component is suspected, as PMR can run in families.
How Is Polymyalgia Rheumatica Diagnosed?
Diagnosing PMR can be challenging because its symptoms overlap with several other conditions, including rheumatoid arthritis, fibromyalgia, and various forms of inflammatory arthritis. At Bolad Clinic, our specialists conduct a thorough physical examination alongside blood tests and, where needed, imaging studies.
What to Expect During Your Diagnostic Appointment
A typical diagnosis involves:
Medical history review: Your doctor will ask about the nature of your symptoms, when they started, how long morning stiffness lasts, and which areas of your body are affected.
Physical examination: This typically includes a range of motion assessment for the shoulders, hips, and neck.
Blood tests: Elevated ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) levels are common markers of inflammation in PMR.
Ultrasound or MRI: Imaging can detect bursitis (inflammation of the fluid-filled sacs near joints) which is commonly associated with PMR.
Response to corticosteroids: A rapid and dramatic improvement in symptoms with low-dose corticosteroids is often considered confirmatory of PMR.
Polymyalgia Rheumatica Treatment: Your Options
The good news is that polymyalgia rheumatica treatment is generally very effective. Most patients experience significant relief within days of starting therapy. Treatment is tailored to the individual patient at Bolad Clinic and typically involves a structured, supervised approach.
Corticosteroids — The Primary Treatment for PMR
Prednisolone (a type of corticosteroid) is the mainstay of PMR treatment. It works by suppressing the immune system's overactive inflammatory response. Most patients begin to feel dramatically better within one to three days of starting treatment — a relief that is often described as life-changing after months of debilitating pain.
Treatment typically follows a tapering protocol:
An initial higher dose to achieve rapid symptom control
Gradual dose reduction over 12–24 months, guided by symptoms and blood test results
Regular monitoring for side effects, including bone density loss, elevated blood sugar, and raised blood pressure
Monitoring and Supportive Therapies
Long-term steroid use requires careful monitoring and protective measures. Our team at Bolad Clinic takes a proactive approach to managing treatment side effects, which may include:
Calcium and vitamin D supplementation to protect bone health
Regular bone density (DEXA) scans
Blood pressure and blood glucose monitoring
Bisphosphonate therapy to prevent steroid-induced osteoporosis where appropriate
Physical therapy and gentle exercise to maintain strength and mobility
Living With Polymyalgia Rheumatica — Lifestyle Tips to Help Symptoms Improve
In addition to medical treatment, lifestyle modifications play an important role in managing PMR and helping symptoms improve over time. Many patients who ask "how I cured my polymyalgia rheumatica" report that a combination of medical treatment and positive lifestyle changes made the greatest difference.
Stay gently active: Low-impact exercises such as walking, swimming, or yoga can help maintain joint flexibility and muscle strength without aggravating inflammation.
Anti-inflammatory diet: A Mediterranean-style diet rich in oily fish, fresh vegetables, fruits, whole grains, and olive oil may help reduce systemic inflammation.
Rest and pacing: Balance activity with rest, especially during flares. Pushing through severe pain can worsen inflammation.
Mental health support: Living with chronic pain is challenging. Consider speaking with a counsellor or joining a PMR support group to connect with others who understand your experience.
Avoid smoking: Smoking increases inflammation and has been linked to poorer outcomes in inflammatory conditions.
Is It PMR? Comparing Polymyalgia Rheumatica to Other Common Conditions
PMR can look similar to several other musculoskeletal and inflammatory conditions. Getting the correct diagnosis early is essential to ensure you receive the right treatment.
Here is how PMR compares to other common symptoms and conditions:
Rheumatoid arthritis (RA): RA tends to cause more joint swelling and affects smaller joints like the hands and feet. Blood tests (rheumatoid factor, anti-CCP) help differentiate the two.
Fibromyalgia: Fibromyalgia typically involves widespread body pain with normal inflammatory blood markers — unlike PMR, which is associated with significantly elevated ESR and CRP.
Hypothyroidism: An underactive thyroid can cause fatigue, stiffness, and muscle aches, making it important to rule out with a simple blood test.
Sciatica: Sciatic nerve pain is typically one-sided and radiates down the leg, whereas PMR causes bilateral stiffness and pain centred on the proximal muscles.
Frequently Asked Questions About Polymyalgia Rheumatica
Can polymyalgia rheumatica be cured?
Many patients do achieve full remission from PMR after a course of treatment lasting one to two years. However, around 50% of patients experience a relapse when trying to reduce or stop steroids. With proper monitoring and dose adjustment, most patients manage well long-term. While not everyone experiences a permanent cure, the majority go on to live active, pain-free lives with the right management plan.
What is poly rheumatica and how is it different from other types of arthritis?
"Poly rheumatica" is an informal term for polymyalgia rheumatica. Unlike most forms of arthritis, PMR primarily affects the muscles and the tissue around joints rather than causing joint destruction. It does not typically cause the joint erosions seen in rheumatoid arthritis.
What is polymyalgia rheumatica disease and who is most at risk?
Polymyalgia rheumatica disease is a chronic inflammatory condition that primarily affects older adults. People most at risk are those aged 50 and over, women, and individuals of Northern European descent. It is the most common inflammatory rheumatic condition in the over-50 age group.
How long does PMR treatment last?
Most people require corticosteroid treatment for one to two years. The dose is carefully tapered downward over time. Stopping treatment too quickly is one of the most common causes of relapse, which is why regular follow-up with your specialist team at Bolad Clinic is so important.
Why Choose Bolad Clinic for Polymyalgia Rheumatica Treatment?
At Bolad Clinic, we understand that living with PMR can be physically and emotionally draining. Our specialist team combines cutting-edge diagnostic tools, personalised treatment plans, and ongoing monitoring to support you through every stage of your condition.
Expert rheumatology team: Our consultants have extensive experience in diagnosing and managing PMR and related inflammatory conditions.
Rapid access appointments: We prioritise prompt assessment to minimise the time you spend in pain before receiving an accurate diagnosis.
Comprehensive care: From blood test monitoring to physiotherapy and bone health management, we offer holistic support under one roof.
Patient education: We believe informed patients achieve better outcomes. Our team takes the time to explain your diagnosis, treatment options, and what to expect at every stage.
Book a Consultation at Bolad Clinic Today
If you are experiencing symptoms that could indicate polymyalgia rheumatica — including persistent shoulder or hip stiffness, pain that is worse in the morning, and fatigue do not wait to seek help.
Early diagnosis and treatment can transform your quality of life and help prevent serious complications such as vision loss associated with giant cell arteritis.
Contact Bolad Clinic today to book an appointment with one of our specialist consultants. We are here to help you get back to living the life you love.