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Polymyalgia rheumatica - Management
What are the symptoms of polymyalgia rheumatica?
- Onset — the onset of polymyalgia rheumatica is usually rapid, but may be insidious. However, symptoms may have been present for weeks or months before the diagnosis is made .
- Muscle pain — shoulder pain is the presenting feature in 70–95% of people, with the hips and neck being less frequently involved (50–70%). The pain usually radiates distally towards the elbows and knees. It can begin in one shoulder or hip but soon becomes bilateral. Pain is more severe with movement and interferes with sleep at night.
- Stiffness — stiffness after periods of rest, and morning stiffness of more than 45 minutes are typical. The stiffness may be so profound that the person may have great difficulty turning over in bed, rising from a bed or a chair, or raising their arms above shoulder height (for example to comb their hair).
- Low-grade fever, fatigue, anorexia, weight loss, and depression (systemic symptoms) occur in up to 40% of people.
- Headache, scalp tenderness, and visual disturbances, (symptoms indicative of giant cell arteritis) may be present in 10–20% of people with polymyalgia rheumatica.
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