By Dr. Paul Tuttle, OSMS Board-Certified Adult and Pediatric Rheumatologist
Polymalgia rheumatica is an inflammatory autoimmune disease that usually impacts people over age 50 with the average age being in the 70’s. It happens more in women than men and more in Caucasians than other races. Patients will describe muscle pain in the shoulder and hip area associated with stiffness that is especially worse in the morning. There can be swelling in the joints but this is not commonly seen.
The cause of this disease is unknown but it is felt that infections could be a trigger in an genetically susceptible individual. This inflammatory disease primarily affects the large blood vessels of the body but sometimes also can be associated with the smaller blood vessels such as the temporal artery in an associated disease called temporal arteritis or giant cell arteritis.
If you have polymyalgia rheumatica and start to experience vision changes or headaches you should call your rheumatologist right away to see if you could have this coexisting more severe inflammatory disease. Due to this inflammation in the blood vessels people will often have very elevated inflammatory markers in the blood which usually normalizes on treatment.
This disease tends to respond very well and very quickly to lower dose steroids unlike most other inflammatory diseases. Your rheumatologist will do testing to rule out other inflammatory diseases that sometimes can look similar to polymyalgia rheumatica. A slow taper of these steroids are needed to prevent relapses which can happen if the steroids are tapered too quickly. It can return but often it does not with a slow steroid taper. Patients are often on steroids for 6-12 months and sometimes longer.