Treatment for Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory condition that can cause aching and stiffness. It tends to affect the neck, shoulders, and hips. The aching and stiffness are usually worse in the morning.

Types of treatment

Steroid medicine is the main treatment for PMR. Your healthcare provider will start you on a low dose of this medicine. You should start to feel better soon after starting. When your symptoms are better, your healthcare provider will slowly lower the amount of medicine. If your symptoms return, they will increase the dose. You may need to take steroid medicine for a few years. Return of symptoms is common, so you may need to take steroid medicine again in the future. If untreated, PMR may go away on its own after several years. But symptoms will likely return.

Watching for giant cell arteritis

Some people with PMR also have a condition called giant cell arteritis. It's also called temporal arteritis or Horton arteritis. This is inflammation of blood vessels in the head, neck, and arms. This can narrow or block the blood vessels. It can cause problems from less blood flow through those vessels. Giant cell arteritis can cause symptoms such as:

  • Headaches

  • Changes in vision

  • Jaw pain, especially when chewing

  • Scalp pain

  • Scalp sores (ulcers)

  • High fevers

Possible complications of giant cell arteritis may include blindness or stroke.

Giant cell arteritis can also be treated with steroid medicine. Research on a medicine that suppresses the immune system shows that it may be used to treat giant cell arteritis and PMR in the future. The medicine is called tocilizumab.

Risks of long-term steroid use

Steroid medicine has some risks. Talk with your healthcare provider about the risks and benefits for you. Some of the possible risks of taking steroids for a long time can include:

  • High blood pressure

  • Diabetes

  • Glaucoma

  • Cataracts

  • Osteoporosis

  • Fluid retention

  • Weight gain

  • Roundness of the face

  • Stomach irritation

  • Trouble sleeping

  • Muscle wasting

  • Skin thinning

  • Easy bruising

  • Poor wound healing

  • Higher risk for infections

Living with polymyalgia rheumatica

If you have PMR, your symptoms will get better with treatment. Once you start feeling better, you can return to your normal activities. Your healthcare provider will track your symptoms and adjust your steroid dose until you are on the lowest dose needed. Small changes in steroid doses can have a big effect on your symptoms. Make sure to follow your healthcare provider’s instructions.

When to call 911

Call 911 if you have symptoms of a stroke, such as:

  • Severe headache

  • Trouble seeing

  • Balance or coordination problems

  • Weakness or numbness

  • Confusion

  • Trouble speaking

If you think you are having a stroke, note the time when your symptoms started.

When to call your healthcare provider

Call your healthcare provider if you have any of the following:

  • Symptoms that don’t get better with treatment

  • New symptoms

  • Symptoms that get worse

  • Symptoms of giant cell arteritis