It takes its name from the Greek word Πολυμυαλγία polymyalgia, which means "pain in many muscles". Signs and symptoms
A wide range of symptoms can indicate if a person has polymyalgia rheumatica. The classic symptoms include:
Pain and stiffness (moderate to severe) in the neck, shoulders, upper arms, thighs, and hips, which inhibits activity, especially in the morning/after sleeping. Pain can also occur in the groin area and in the buttocks. The pain can be limited to one of these areas as well. It is a disease of the "girdles" meaning shoulder girdle or pelvic girdle. Fatigue and lack of appetite (possibly leading to weight loss)
Anemia
An overall feeling of illness or flu-like symptoms. Low-grade (mild) fever or abnormal temperature is sometimes present. In most people, it is characterized by constant fatigue, weakness and sometimes exhaustion.About 15% of people who are diagnosed with polymyalgia rheumatica also have temporal arteritis, and about 50% of people with temporal arteritis have polymyalgia rheumatica. Some symptoms of temporal arteritis include headaches, scalp tenderness, jaw or facial soreness, distorted vision, or aching in the limbs caused by decreased blood flow, and fatigue. Causes
The cause of PMR is not well understood. The pain and stiffness result from the activity of inflammatory cells and proteins that are normally a part of the bodys disease-fighting immune system, and the inflammatory activity seems to be concentrated in tissues surrounding the affected joints. During this disorder, the white blood cells in the body attack the lining of the joints, causing inflammation.
Inherited factors also play a role in the probability that an individual will develop PMR. Several theories have included viral stimulation of the immune system in genetically susceptible individuals.Infectious diseases may be a contributing factor. This would be expected with sudden onset of symptoms, for example. In addition, new cases often appear in cycles in the general population, implying a viral connection. Studies are inconclusive, but several somewhat common viruses were identified as possible triggers for PMR. The viruses thought to be involved include the adenovirus, which causes respiratory infections; the human parvovirus B19, an infection that affects children; and the human parainfluenza virus. Some patients attribute the onset of PMR to stress.Persons having the HLA-DR4 type of human leucocyte antigen appear to have a higher risk of PMR. Diagnosis
No specific test exists to diagnose polymyalgia rheumatica; many other diseases can cause inflammation and pain in muscles, but a few tests can help narrow down the cause of the pain. Limitation in shoulder motion, or swelling of the joints in the wrists or hands, are noted by the doctor. A patients answers to questions, a general physical exam, and the results of tests can help a doctor determine the cause of pain and stiffness.One blood test usually performed is the erythrocyte sedimentation rate (ESR) which measures how fast the patients red blood cells settle in a test tube. The slower the red blood cells settle, the higher the ESR value (measured in mm/hour), which means inflammation is present.