Polymyalgia: Understanding the Pain, Stiffness, and How To Manage It

Understanding Polymyalgia: What It Is

Polymyalgia rheumatica (PMR) is an inflammatory condition that mainly affects individuals over the age of 50. It causes pain and stiffness in large muscle groups—especially the neck, shoulders, and hips. This discomfort is typically bilateral, meaning it occurs on both sides of the body, and is usually most severe in the morning or after periods of inactivity.

PMR affects about 50 out of every 100,000 people each year in the U.S. and is more common in women and individuals of Northern European descent. While the exact cause is unknown, it’s considered an autoimmune disorder, where the immune system mistakenly attacks the body’s own tissues. PMR often comes on suddenly and can significantly affect quality of life if not properly managed.

Common Symptoms of Polymyalgia

The hallmark symptoms of polymyalgia rheumatica include sudden muscle pain and stiffness, especially in the shoulders, upper arms, hips, and thighs. These symptoms usually appear quickly, sometimes even overnight, and tend to worsen after periods of rest or sleep. Morning stiffness lasting longer than 30 minutes is one of the most characteristic signs.

In addition to pain and stiffness, individuals may experience fatigue, weakness, and general malaise. Other symptoms can include low-grade fevers, weight loss, and a loss of appetite. Some may even notice swelling in the hands or wrists. Because these symptoms can resemble those of other conditions, proper medical evaluation is essential for accurate diagnosis and effective treatment.

What Causes Polymyalgia?

Although the exact cause of polymyalgia rheumatica remains unclear, several factors may contribute to its development. Genetics appears to play a role, as PMR tends to run in families. Environmental factors, such as infections, may also trigger the condition, though no specific infectious agent has been identified.

Age is the most significant risk factor—PMR rarely occurs in people under 50 and is most common between ages 70 and 75. Women are more frequently affected than men, and people of Northern European ancestry have a higher likelihood of developing it. Researchers also suspect an autoimmune response may be involved, where the body’s immune system attacks healthy tissues, leading to inflammation and pain.

Managing Polymyalgia With Medication

The first line of treatment for polymyalgia is corticosteroids, typically a low dose of prednisone. Most patients experience rapid relief within days of starting treatment. Once symptoms are under control, doctors gradually taper the dose to minimize side effects while maintaining long-term symptom relief.

However, long-term steroid use can bring complications such as weight gain, osteoporosis, high blood pressure, and diabetes. To counter these risks, healthcare providers may recommend additional medications like methotrexate or biologics, though more research is needed to confirm their effectiveness. It’s essential to work closely with a doctor to adjust medications as needed and to monitor for side effects throughout treatment.

Lifestyle and Dietary Strategies for Relief

In addition to medication, lifestyle changes play an important role in managing polymyalgia. Regular exercise, such as walking, swimming, or riding a stationary bike, can help maintain flexibility and muscle strength. Physical therapy may also be recommended to reduce stiffness and promote mobility.

Diet can impact symptoms and help manage corticosteroid side effects. A balanced, anti-inflammatory diet rich in fruits, vegetables, lean protein, healthy fats, and whole grains is ideal. This approach supports overall health and helps counter issues like weight gain, high blood pressure, and bone thinning caused by long-term steroid use. Always consult a healthcare provider before making significant dietary changes, especially if other conditions are present.

Taking Control of Polymyalgia With Knowledge and Care

Living with polymyalgia rheumatica can be difficult, but early recognition, proper treatment, and lifestyle adjustments make a real difference. Understanding the symptoms and causes empowers individuals to seek help before the condition severely impacts daily life.

With the right combination of medical support, exercise, and a balanced diet, most people with PMR can regain comfort and mobility. Staying informed and proactive is the key to managing symptoms and maintaining a good quality of life.