Polymyalgia rheumatica is a type of inflammatory disorder that causes a multitude of symptoms. Prominent symptoms include muscle aches, morning stiffness and general health complaints such as fatigue. The onset of symptoms can be gradual or sudden, and risk factors include increasing age, being female and race (whites predominately affected). The condition also has a high association with giant cell arteritis (inflammatory condition involving the arteries). Treatment often includes steroids such as prednisone, which controls the symptoms of both polymyalgia rheumatic and giant cell arteritis (if present).
Morning Stiffness
The morning stiffness of polymyalgia rheumatica usually last over an hour, with an average duration of two to three hours. Difficulty getting out of bed is one of the primary manifestations of this symptom.
Constitutional Symptoms
These refer to nonspecific symptoms affecting general health, such as feelings of malaise, depression and low-grade fever. These all point to a systemic inflammation, and in fact are found in most inflammatory diseases.
Pain
The most common symptom, pain is commonly localized to the shoulder, low back and the thigh/hip area. It can also occur in the temporal area due to inflammation as a result of disease like giant cell arteritis that often accompanies polymyalgia rheumatic.
Giant Cell Arteritis
This is an associated disease with a predilection for the temporal and ophthalmologic arteries. Symptoms include visual changes, jaw pain and swollen/tender arteries in the temples. These are very important symptoms and must be managed as a medical emergency, as blindness can result without treatment. About half the people with polymyalgia rheumatic have giant cell arteritis.
Weakness/Fatigue
This is usually the result of anemia, or decreased red blood cells. Anemia can also be the result of any prolonged systemic inflammatory disorder, and in this case is known as anemia of chronic disease. It results from changes in red blood cell metabolism in response to chronic inflammation.
References
- "Kelley's Textbook of Rheumatology, 8th Edition;" Firestein; 2008
- "Ferri's Clinical Advisor 2010, 1st Edition;" Ferri; 2009
- "Neurologic Clinics"; Neck and Back Pain: Musculoskeletal Disorders; Meleger, A., Krivickas, L.; May 2007
