Polymyalgia rheumatica (PMR) Dr Rob Hicks PMR is a debilitating condition in which the muscles supporting the neck, shoulders, hips and thighs become inflamed.

In this article

What causes it? What are the symptoms?

Who's affected? What's the treatment?

Nobody knows what causes the pain of PMR. However, it often develops quite suddenly after a flu-like viral infection.

The pain and stiffness generally build up over a week or two, making it difficult to function properly. Climbing stairs, walking, and getting in and out of the bath become uncomfortable and many previously active people find themselves housebound.

Sometimes lifting a fork or spoon becomes impossible. In severe cases, the pain may mean someone becomes bed-bound.

The symptoms are worse first thing in the morning, which means it's often hard to get out of bed. The pain also tends to increase after sitting down for prolonged periods.

In addition to the pain and stiffness, many people experience extreme tiredness and feel very unwell. Some may lose weight.

The majority of people affected are over the age of 50. Women are more likely to get PMR than men.

PMR can't be prevented but the symptoms are easily treated with medication.

Steroid medication in tablet form, usually prednisolone, reduces inflammation and brings rapid and dramatic improvement. The benefits are often felt within 48 hours.

Regular monitoring with a blood test called ESR is essential to measure the level of inflammation in the body. This, combined with a regular review of symptoms, gives an idea of how well the treatment is working and enables the doctor to adjust the dose as necessary.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may also help. Physiotherapy can improve the function of the muscles once the pain and stiffness have subsided.

People often need to remain on medication for about two years. During this time the dose should be kept to the absolute minimum required. Being on oral steroid medication for a long time can thin the bones and lead to osteoporosis.

For this reason it's important to have plenty of calcium and vitamin D in the diet and, when able, to do weight-bearing exercises such as brisk walking. The doctor may also suggest taking a calcium and vitamin D supplement.

PMR eventually burns itself out and medication can be stopped. However, this should only be done under the supervision of the doctor.

This article was last medically reviewed by Dr Rob Hicks in July 2006.