Polymyalgia rheumatica is an inflammatory condition that causes pain and stiffness, mainly around the shoulders and hips. It almost always occurs in people over the age of 50, and becomes more common with increasing age.

• Stiffness is usually worst in the morning and after rest, and typically lasts longer than 30–45 minutes.
• Onset can be surprisingly sudden — some patients wake up one day struggling to lift their arms or get out of bed.
• PMR is closely linked to Giant Cell Arteritis (GCA), a related condition that inflames blood vessels in the head and can threaten vision if untreated — about 1 in 5 PMR patients also has GCA.
• The good news: PMR usually responds dramatically well to low-dose steroids, often within days.

• Pain and stiffness in both shoulders, often spreading to the neck, upper arms and hips
• Stiffness that is worse in the morning and improves somewhat through the day
• Difficulty rising from a chair, turning over in bed, or raising the arms above the head
• Mild fever, fatigue, low appetite and unintentional weight loss
• Low mood, in part from disrupted sleep and constant discomfort

• The exact cause of polymyalgia rheumatica is not fully known.
• It is thought to involve a combination of genetic susceptibility and an abnormal immune response, possibly triggered by an infection in some cases.
• It shares a close biological relationship with Giant Cell Arteritis (GCA) — the two conditions are believed to be different expressions of the same underlying inflammatory process.
• It is not caused by wear-and-tear or overuse, and it is not contagious.

• Clinical evaluation of the pattern, distribution and duration of stiffness, along with age and how suddenly it began.
• Blood tests for inflammation markers — ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) — which are usually significantly raised in PMR.
• Screening for symptoms of Giant Cell Arteritis — new headache, scalp tenderness, jaw pain while chewing, or visual disturbance — since GCA needs urgent treatment to prevent vision loss.
• Other blood tests and sometimes imaging to rule out rheumatoid arthritis and other causes of similar symptoms.

Low-dose steroids — the mainstay of treatment

PMR responds very well to a low dose of a corticosteroid (usually prednisolone), typically bringing dramatic relief of pain and stiffness within a few days. This rapid response is itself one of the ways rheumatologists confirm the diagnosis.

A gradual, supervised taper

The steroid dose is slowly reduced over many months under close rheumatology follow-up, since tapering too quickly can cause symptoms to flare back. Most patients need treatment for one to two years, and some longer.

Watching for Giant Cell Arteritis

Because PMR and GCA are closely linked, your rheumatologist will keep checking for new symptoms like headache, scalp tenderness or visual changes throughout treatment — GCA needs urgent, higher-dose treatment to protect vision.

Protecting bone health

Since treatment involves steroids over a prolonged period, we also monitor bone density and may recommend calcium, vitamin D or bone-protective medication to reduce osteoporosis risk.

Consultations with the OARC rheumatology team run Monday to Saturday, 9:00 AM–2:00 PM and 4:30–9:00 PM. Call +91 93386 53086 or book online.

• Most people with PMR respond quickly and well to treatment and can return to normal activities within days to weeks of starting steroids.
• PMR is not usually life-threatening on its own, but untreated Giant Cell Arteritis can cause permanent vision loss — new head or vision symptoms should always be reported promptly.
• With a properly supervised steroid taper, most patients eventually stop treatment entirely once the underlying inflammation has settled.