Polymyalgia Rheumatica
Expert diagnosis and personalized treatment at Arthritis Care of Los Angeles.
What is Polymyalgia Rheumatica?
Polymyalgia rheumatica (PMR) is an inflammatory disorder that causes widespread muscle pain and stiffness, particularly in the shoulders, neck, upper arms, and hips. The pain and stiffness are typically worse in the morning and can make everyday activities like getting out of bed, raising your arms above your head, or climbing stairs very difficult. PMR almost exclusively affects adults over age 50 and is one of the most common inflammatory conditions in older adults. The exact cause of PMR is not fully understood, but it involves inflammation of the lining of the joints and surrounding tissues. PMR is closely associated with giant cell arteritis (GCA), a serious condition that causes inflammation of blood vessels, particularly in the head. About 10-20% of people with PMR also develop GCA, which makes careful monitoring essential. With proper treatment, most people with PMR experience significant relief within days. At Arthritis Care of Los Angeles, Dr. Forouzesh provides expert diagnosis and management of polymyalgia rheumatica at both our Culver City and Encino locations. Early treatment is important to reduce inflammation, relieve symptoms, and screen for associated conditions like giant cell arteritis.
Common Symptoms
- Aching and stiffness in the shoulders and upper arms
- Pain and stiffness in the hips, thighs, and neck
- Morning stiffness lasting more than 45 minutes
- Difficulty with daily activities like dressing or reaching overhead
- Fatigue and general feeling of being unwell
- Low-grade fever and unintentional weight loss
- Reduced range of motion in affected areas
- Symptoms on both sides of the body (bilateral)
Experiencing these symptoms? Get expert care today.
How is Polymyalgia Rheumatica Diagnosed?
Diagnosing polymyalgia rheumatica requires a careful evaluation because there is no single definitive test for the condition. Dr. Forouzesh uses a combination of clinical assessment, blood tests, and imaging to reach an accurate diagnosis. Blood tests typically reveal elevated inflammatory markers, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Additional blood work helps rule out other conditions such as rheumatoid arthritis, lupus, and thyroid disorders. Ultrasound or MRI imaging may be used to detect inflammation in the shoulders and hips. Because of the strong association with giant cell arteritis, Dr. Forouzesh also screens for symptoms of GCA such as headache, jaw pain, and vision changes during every visit.
Treatment Options
Low-Dose Corticosteroids
Prednisone at a low dose is the cornerstone of PMR treatment. Most patients experience dramatic improvement within one to three days. The dose is gradually tapered over 12 to 24 months based on symptoms and inflammatory markers.
Steroid-Sparing Medications
Methotrexate or other immunosuppressive medications may be added for patients who have difficulty tapering corticosteroids or who experience frequent relapses.
Monitoring for Giant Cell Arteritis
Regular screening for GCA symptoms is an essential part of PMR management. Patients are educated on warning signs that require immediate medical attention.
Bone Health Protection
Calcium, vitamin D supplementation, and bone density monitoring to protect against osteoporosis during long-term corticosteroid use.
Physical Therapy and Exercise
Gentle stretching and strengthening exercises to maintain range of motion, improve flexibility, and support recovery as inflammation is controlled.
Key Statistics
1 in 133
People over 50 affected by PMR
Source: American College of Rheumatology
2-3x
More likely in women than men
Source: NIH/NIAMS
70
Average age of onset (years)
Source: Arthritis Foundation
Frequently Asked Questions
Ready to Get Expert Care?
Schedule your appointment with Dr. Solomon Forouzesh, MD, FACP, FACR — a board-certified rheumatologist with 50++ years of expertise in arthritis and autoimmune diseases.