An Overview of
Polymyalgia Rheumatica (PMR) is one of a family of disorders that are autoimmune in nature. These disorders attack the musculoskeletal system.
In a normal immune response, alien proteins such as those of bacterial or viral origin trigger the immune system to destroy the invading organism. In an autoimmune disorder, the immune system becomes confused and develops sensitivity to normal body proteins. In the case of PMR, the muscle proteins are the targets of this disorder.
When the immune response mistakenly identifies these normal host proteins as “foreign invaders”, inflammation, swelling, and destruction of muscle cells can occur. This is the basis of an autoimmune disorder.
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Polymyalgia Rheumatica causes muscle pain and stiffness. The pain can come on very suddenly, or can occur gradually over a period of time. Symptoms tend to be worse in the morning and are bilaterally symmetrical (equal on both sides). The shoulders, neck and arms are the most commonly involved with the hips as the second most common location. Any muscle group can however be prone to this disease.
Most patients with PMR wake up in the morning with pain in the muscles but the pain can intensify at any time of day. Lethargy (tiredness) is a common complaint. Loss of appetite (anorexia) is also associated.
Surgery can provoke the onset of PMR, even in younger patients. PMR may be brought on by a viral or trauma origin of some type, but genetics does play a factor as well. Most patients who develop this disorder are older individuals.
Polymyalgia Rheumatica is related to another inflammatory disorder called giant cell arteritis, which can cause headaches, vision difficulties, jaw pain and scalp tenderness. It is possible to have both of these conditions together.
Diagnosis and Treatment
No specific test exists to diagnose polymyalgia rheumatica and many other diseases can cause inflammation and pain in muscles. There are no absolute diagnostic laboratory tests, but CRP (C Reactive Protein) and ESR (Erythrocyte Sedimentation Rate) can be indicators of inflammation. Unfortunately, both lab tests also elevate after surgery.
This disorder is treated with the oral use of steroids. Non-steroidal anti-inflammatories (NSAIDs) are not effective for treatment.
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