Materiały źródłowe

• #1 An update on polymyalgia rheumatica

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9796644/

  Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatic disease affecting people older than 50 years and is 23 times more common in women. The most common symptoms are pain and morning stiffness in the shoulder and pelvic girdle and the onset may be acute or develop over a few days to weeks. General symptoms such as fatigue, fever and weight loss may occur, likely driven by systemic IL6 signalling. […] A characteristic feature of PMR is a new and relatively acute onset of proximal muscle pain and stiffness in the neck, shoulders, upper arms, hips and thighs. Patients often suffer from a pronounced morning stiffness with difficulty turning in or getting out of bed in the morning with some spontaneous relief of symptoms later in the day. The stiffness affects even other physical activities in the morning, including getting dressed or taking care of other daily activities. The symptoms are usually fully developed within a few days to a couple of weeks. Occasionally, the onset is more insidious and may lead to nonspecific symptoms such as fatigue, arthralgia, loss of appetite, weight loss or fever.

• #2

  https://www.nhs.uk/conditions/polymyalgia-rheumatica/

  Polymyalgia rheumatica (PMR) is a condition that causes pain, stiffness and inflammation in the muscles around the shoulders, neck and hips. […] The main symptom is muscle stiffness in the morning that lasts longer than 45 minutes. […] Other symptoms may include: extreme tiredness, loss of appetite, weight loss, depression. […] Diagnosing polymyalgia rheumatica can be difficult because the symptoms are similar to those of many other conditions, including rheumatoid arthritis. […] Most people diagnosed with it are over 65, and it’s very rare in people younger than 50. It’s also more common in women than men. […] Most people with polymyalgia rheumatica will need a course of steroid treatment that lasts for 12 months to 2 years to prevent their symptoms returning.

• #3 Patient education: Polymyalgia rheumatica and giant cell arteritis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/polymyalgia-rheumatica-and-giant-cell-arteritis-beyond-the-basics/print

  Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA, also known as Horton disease, cranial arteritis, and temporal arteritis) are inflammatory conditions that affect different parts of the body. The most common symptoms of polymyalgia rheumatica (PMR) are: Aching and stiffness in the morning in the shoulders and upper arms, hips and thighs, and back of the neck. Some people have trouble getting dressed (eg, fastening a bra, putting on a shirt or jacket, or pulling on stockings). Difficulty raising the arms above the shoulders is a typical symptom. Morning stiffness is often severe, can last for several hours, and can return during the day after inactivity. Occasional swelling or stiffness of the small joints of the hands, wrists, and knees. Feeling of tiredness, poor appetite, weight loss, or low-grade fever. Symptoms of PMR come on quickly over a period of weeks or even days. Most people who are diagnosed with PMR: Are older adults in their 60s or 70s. PMR almost never occurs under the age of 50. Have persisting aching and morning stiffness (lasting 30 minutes or more) on both sides of the body, and involving at least two of the following three areas: neck or upper body, shoulders or upper arms, and hips or upper thighs. Have an elevated level of inflammation, which can be measured with a blood test (the erythrocyte sedimentation rate [ESR] or C-reactive protein [CRP]). In most people, polymyalgia rheumatica (PMR) tends to run its course over time, and glucocorticoid therapy can eventually be stopped. […] Almost one-half of people with GCA have polymyalgia rheumatica (PMR). Up to 20 percent of people with PMR have GCA. It is not clear why the conditions often occur together.

• #4 Polymyalgia Rheumatica | UMass Memorial Health

  https://www.ummhealth.org/health-library/polymyalgia-rheumatica

  Other symptoms can happen, such as: Swelling of the hands, wrists, feet, and ankles, Numbness, tingling, or pain in the hand, wrist, or forearm, Feeling of weakness, General feeling of being unwell, Feeling tired, Loss of appetite, Weight loss, Low-grade fever. […] PMR can come on suddenly. For some, it seems to happen overnight. For others, it can take days or weeks to develop. PMR affects only older adults. It becomes more common with age. PMR happens most often between the ages of 70 and 80. It can be seen as early as 50 years of age. It’s more common in women than in men, and it seems to run in some families. […] If untreated, PMR may go away on its own after several years. But symptoms will likely return.

• #5 Polymyalgia Rheumatica | Arthritis Foundation

  https://www.arthritis.org/diseases/polymyalgia-rheumatica

  Polymyalgia rheumatica (PMR) is a form of inflammatory arthritis that mainly affects the shoulders, arms, hips and low back. Symptoms like pain and stiffness often appear suddenly sometimes literally overnight but can also develop over a few days or weeks. They usually occur on both sides of the body, are worse in the morning or after resting and get better with movement. For some people, morning pain and stiffness can make it hard to get out of bed or dress. About one-third of patients also develop systemic symptoms like fever, fatigue and unintended weight loss. […] PMR is challenging to diagnose because many other conditions have similar symptoms. Doctors often use ultrasound imaging to help pin down a diagnosis. Another way to confirm that its PMR instead of, say, osteoarthritis (OA) is to start a course of the corticosteroid drug, prednisone. PMR almost always gets better with prednisone within just a few days.

• #6 Polymyalgia rheumatica | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/polymyalgia-rheumatica

  Polymyalgia rheumatica is an inflammatory condition. It causes joint and muscle pain and stiffness, mainly in the shoulders and hips. Symptoms of polymyalgia rheumatica may begin quickly or come on over several days to weeks. Symptoms are most often worse in the morning. […] The symptoms of polymyalgia rheumatica most often affect both sides of the body. They might include: Aches or pain in the shoulders. Aches or pain in the neck, upper arms, buttocks, hips or thighs. Stiffness in affected areas, mainly in the morning or after not being active for a time. Less range of motion in affected areas. Pain or stiffness in the wrists, elbows or knees. […] Other symptoms might include: Mild fever. Tiredness. A feeling of not being well, called malaise. Not wanting to eat. Weight loss that happens without trying. Being depressed. […] Symptoms of polymyalgia rheumatica can make it hard to do daily activities, such as: Getting out of bed, standing up from a chair or getting out of a car. Combing the hair or bathing. Getting dressed.

• #7 Polymyalgia Rheumatica: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/25215-polymyalgia-rheumatica

  Polymyalgia rheumatica is a condition that causes aches, pain and stiffness in large muscle groups, including your hips and shoulders. The symptoms are usually worse in the morning and may go away with activity. Polymyalgia rheumatica causes a sudden onset of pain and stiffness in your neck, shoulders and upper arms, hips, thighs and butt. Youll usually feel the pain and stiffness on both sides of your body. The aching and stiffness are usually worse in the morning or when you havent moved in a while. Morning stiffness usually lasts at least 30 minutes or more. The most common symptoms of polymyalgia rheumatica are the sudden onset of pain and stiffness around your large joints, especially around your shoulders and hips. You may also notice discomfort in your arms, back, butt and neck. The aches and pains generally come on within two weeks, even overnight. Youll usually feel the pain on both sides of your body. You might have trouble performing ordinary tasks like getting dressed or brushing your hair. Other polymyalgia rheumatica symptoms may include: Stiffness lasting more than 30 minutes, especially in the morning and after resting. Weakness. Fatigue. Generally feeling ill. Loss of appetite. Weight loss. Swelling of your hands or wrists. Mild fevers. Left untreated, polymyalgia rheumatica can interfere with your mobility. This can make it hard for you to perform your daily activities including bathing, dressing, brushing your hair, getting up from the couch and getting in and out of your car. Raising your arms over your shoulders may be particularly difficult. With treatment, the symptoms of polymyalgia rheumatica typically lessen or disappear altogether within days. Early diagnosis and treatment can increase your chances of quickly recovering from the condition. Most people go on to live typical, productive lives. Severe impairment and disability are rare. With treatment, symptoms of polymyalgia rheumatica resolve within a few days. Treatment duration is generally one to two years, but in some cases, longer treatment is necessary and relapses may occur. In some cases, people may require lifelong treatment with a low dose of prednisone (2 mg to 5 mg daily) to prevent recurrence. Without treatment, generally polymyalgia rheumatic doesnt get better. However, in some cases, the condition may go away on its own after a year. It may take up to five years before the condition disappears completely.

• #8 Polymyalgia Rheumatica and Giant Cell Arteritis | NIAMS

  https://www.niams.nih.gov/health-topics/polymyalgia-rheumatica-giant-cell-arteritis

  Polymyalgia rheumatica causes muscle pain and stiffness in the shoulders, upper arms, hip area, and sometimes the neck. The ache and stiffness are usually worse in the morning or when you have not been moving for a while. They can sometimes be very debilitating and tend to improve with activity. […] Symptoms of polymyalgia rheumatica include: Pain and stiffness in the shoulders, neck, upper arms, and hip area. The pain and stiffness are usually worse upon waking in the morning or after resting, and usually last an hour or more. You may have difficulty with activities like getting up from bed or a chair, and dressing and brushing hair. It is also typical to have difficulty raising your arms above the shoulders. […] The symptoms of polymyalgia rheumatica can come on quickly, usually in a matter of a few days, and in some cases even overnight.

• #9 Polymyalgia rheumatica | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/polymyalgia-rheumatica/

  Polymyalgia rheumatica often causes pain and stiffness. This can affect the shoulders, neck and hips. These symptoms can develop quickly over a few days or weeks. Both sides of the body are usually affected. […] The stiffness often feels worse first thing in the morning after you wake up. It usually starts to improve after about 45 minutes as you become more active. […] Polymyalgia rheumatica may also cause: high temperature (fever) and sweating, extreme tiredness (fatigue), loss of appetite, weight loss, depression.

• #10 An update on polymyalgia rheumatica

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9796644/

  Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatic disease affecting people older than 50 years and is 23 times more common in women. The most common symptoms are pain and morning stiffness in the shoulder and pelvic girdle and the onset may be acute or develop over a few days to weeks. General symptoms such as fatigue, fever and weight loss may occur, likely driven by systemic IL6 signalling. […] A characteristic feature of PMR is a new and relatively acute onset of proximal muscle pain and stiffness in the neck, shoulders, upper arms, hips and thighs. Patients often suffer from a pronounced morning stiffness with difficulty turning in or getting out of bed in the morning with some spontaneous relief of symptoms later in the day. The stiffness affects even other physical activities in the morning, including getting dressed or taking care of other daily activities. The symptoms are usually fully developed within a few days to a couple of weeks. Occasionally, the onset is more insidious and may lead to nonspecific symptoms such as fatigue, arthralgia, loss of appetite, weight loss or fever.

• #11 Polymyalgia rheumatica (PMR) | Causes, symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/polymyalgia-rheumatica-pmr/

  Polymyalgia rheumatica can cause pain and stiffness in the shoulders, neck, hips and thighs. […] Polymyalgia rheumatica often comes on quickly, perhaps over a week or two. It can start just after a flu-like illness. The stiffness may be so severe that dressing, reaching, washing, climbing stairs or even getting out of bed may be difficult. […] The pain and stiffness from polymyalgia rheumatica is often widespread, and is worse when resting or after rest. Symptoms can improve with activity or as the day goes on. The pain may also wake you at night. […] Its also common to feel unwell or to have a slight fever, and you may lose weight. At times, tiredness can be overwhelming, this is known as fatigue. The condition can also make you feel low and anxious, and depressed.

• #12 Polymyalgia Rheumatica: Symptoms and Treatment

  https://patient.info/bones-joints-muscles/polymyalgia-rheumatica-leaflet

  Polymyalgia rheumatica causes pain, stiffness and tenderness in large muscles, typically around the shoulders, upper arms and hips. […] The symptoms of PMR are caused by inflammation affecting muscles and joints. […] The most common symptoms include stiffness, pain, aching and tenderness of the large muscles around the shoulders and upper arms. The stiffness may be so bad that you may have difficulty turning over in bed, rising from a bed or a chair, or raising your arms above shoulder height. […] The stiffness is usually worst first thing in the morning. Getting out of bed may be difficult. The stiffness often eases after an hour or so after getting up from bed and as the day goes on. […] Symptoms typically develop over a few days or weeks. However, they develop more slowly in some cases. You may pass it off as aches and pains of getting older when symptoms first start.

• #12 Polymyalgia Rheumatica: Symptoms and Treatment

  https://patient.info/bones-joints-muscles/polymyalgia-rheumatica-leaflet

  Treatment usually works quickly, within a few days. After starting treatment, the improvement in symptoms over 2-3 days is often quite dramatic. […] If symptoms do not greatly ease and go within a week or so of treatment then the diagnosis of PMR may not be correct. […] You are likely to need treatment for at least one to two years. In some people the condition goes away, so the steroids can be stopped after this time. However, many people need treatment for several years, sometimes for life. […] Some people are able to stop treatment after 2-3 years but symptoms sometimes return at a later time (a relapse). If this occurs, the treatment with steroids can be restarted and will usually work well again. […] Between 1 and 2 in every 10 people with PMR also develop a related condition called giant cell arteritis (GCA). This may be at the same time or some time earlier or later than when PMR develops. GCA can be much more serious than PMR.

• #13 Polymyalgia Rheumatica

  https://rheumatology.org/patients/polymyalgia-rheumatica

  Polymyalgia rheumatica (PMR) is a common condition that involves widespread aching and stiffness. It often affects the upper arms, neck, lower back, and thighs. Pain and stiffness usually are worse in the mornings. The most common symptoms of polymyalgia rheumatica are widespread aching and stiff muscles. Symptoms can come on quickly, even overnight. Usually, you feel aches on both sides of your body. It may be hard to raise your arms over your shoulders. Hands and wrists may ache too. PMR aches may be worse in the morning and get better as the day goes by. Stiffness and aches can be so severe that they cause people to have signs like disturbed sleep, trouble getting dressed, such as putting on socks, and problems getting in and out of a car or up from a sofa. […] Symptoms may recur later.

• #14 Recognition and Management of Polymyalgia Rheumatica and Giant Cell Arteritis | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/1115/p676.html

  Polymyalgia rheumatica affects proximal muscles and joints, causing disability in older adults. […] Polymyalgia rheumatica primarily affects the shoulders, neck, and hips with prominent bilateral pain. Systemic findings such as fatigue and weight loss are common, and there is no definitive diagnostic test. Moderate-dose corticosteroid therapy with a slow taper rapidly resolves symptoms. […] Polymyalgia rheumatica primarily affects the muscles and joints of the shoulder, neck, and hip girdles, with prominent bilateral pain and morning stiffness. The shoulders are affected in 95% of cases. Proximal myalgias and arthralgias typically develop over weeks to months, worsening at night and with movement. True muscle weakness, as opposed to limited effort because of pain or atrophy from disuse, is not associated with pure polymyalgia rheumatica; distinguishing weakness from limited effort requires careful examination. Up to 50% of patients with polymyalgia rheumatica display distal, transient, asymmetrical arthritis, primarily in the knee or wrist. Systemic symptoms (low-grade fever, fatigue, malaise, and weight loss) occur in 30% to 50% of patients.

• #14 Recognition and Management of Polymyalgia Rheumatica and Giant Cell Arteritis | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/1115/p676.html

  The mainstay of treatment is corticosteroids with a slow taper, which normally reduces symptoms rapidly. Dosing must be tailored to the patient’s symptoms and inflammatory markers because up to 13% of patients require higher initial doses. The mean length of treatment for polymyalgia rheumatica is 1.8 years, although occasionally a more prolonged course of treatment is necessary. Risk of relapse, which is common, and of concomitant giant cell arteritis correlates with high baseline ESR, older age, female sex, lower (10 mg or less) and higher (greater than 20 mg) starting doses of corticosteroids, fast taper, longer duration of symptoms, and specific human leukocyte antigen alleles.

• #15 Polymyalgia Rheumatica | UMass Memorial Health

  https://www.ummhealth.org/health-library/polymyalgia-rheumatica

  Polymyalgia rheumatica (PMR) is an inflammatory condition that can cause aching and stiffness. It tends to affect the neck, shoulders, and hips. The aching and stiffness are usually worse in the morning. […] The main symptoms of PMR are aching and stiffness of the shoulders, neck, and hips. The aching can extend to the upper arms and thighs. PMR tends to affect both sides of the body equally. Symptoms are often worse in the morning or after long periods of no activity. Movement can make the pain worse. […] The symptoms of PMR usually affect the shoulders the most. You may have trouble raising your arms above the level of your shoulders. This can make it hard to get dressed. You may have trouble rolling over in bed, getting out of bed, and getting up from sitting. You may also have trouble sleeping because of your symptoms.

• #16

  https://bpac.org.nz/2023/pmr.aspx

  Polymyalgia rheumatica (PMR) is an inflammatory rheumatological condition that causes a specific pattern of joint pain and morning stiffness, and almost never occurs in people aged under 50 years. […] The typical presentation of polymyalgia rheumatica (PMR) is a recent onset of aching pain and morning stiffness lasting at least 30 45 minutes, affecting both shoulders and often the neck, the hip girdle and occasionally the lower back. It is almost exclusively seen in people aged 50 years of European ethnicity. […] Symptoms generally improve rapidly after treatment initiation, i.e. within a few days to one week. […] Marked morning stiffness that persists for at least 30 45 minutes is a typical feature of PMR. […] Up to half of all people with PMR experience systemic symptoms such as a low-grade fever, fatigue, loss of appetite, malaise and weight loss.

• #16

  https://bpac.org.nz/2023/pmr.aspx

  Relapse occurs in approximately half of all patients with PMR and is most common within two years of diagnosis. […] Clinical symptoms and signs are the primary markers for relapse with laboratory markers providing supporting information only. […] If a relapse occurs, re-evaluate for alternative diagnoses.

• #17 Polymyalgia rheumatica | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/polymyalgia-rheumatica

  Polymyalgia rheumatica is a common condition that causes pain and stiffness in older adults. Symptoms include severe muscle aches and stiffness, unexplained weight loss and fatigue. […] Typical symptoms include moderate-to-severe muscle pain and stiffness, particularly affecting the neck, shoulders, thighs and hips. […] The symptoms of polymyalgia rheumatica usually develop over a short period of time (days/weeks) and may include: muscle pain and stiffness, particularly in the neck, shoulders, hips, thighs and upper arms, increased pain and stiffness after you’ve been resting or inactive, fatigue (or tiredness), difficulty sleeping (due to pain), difficulty raising arms above shoulder height, weight loss, slight fever. […] Not everyone will experience all of these symptoms. Each person with polymyalgia rheumatica will have their own unique set of symptoms.

• #18 Polymyalgia rheumatica: An updated review | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/549

  Another debated issue is treatment duration, which should generally be patient-specific and symptom-driven. […] Relapses and flares should prompt reevaluation of symptoms and laboratory studies for alternate diagnoses. […] Adverse effects of chronic glucocorticoid use include skin changes, body composition changes, ocular disorders, cardiovascular disorders, gastrointestinal disorders, osteoporosis, mood changes, and renal effects. […] Methotrexate, usually at a starting dosage of 10 to 15 mg per week, is the most commonly used glucocorticoid-sparing therapy for PMR. […] IL-6 plays a major role in sustaining disease activity in PMR, so IL-6 blockade has been explored as a possible treatment, with promising results. […] Regardless of the medication regimen used, patients should be followed closely in the first year after starting treatment.

• #19 Polymyalgia Rheumatica: Symptoms, Tests, and Treatment

  https://www.healthline.com/health/polymyalgia-rheumatica

  You may find that being inactive or remaining in one position for a long period of time can make symptoms worse. The pain and stiffness may eventually become so severe that you have difficulty performing everyday activities, such as standing up from the couch, getting dressed, or getting into a car. Sometimes, the symptoms of polymyalgia rheumatica can even make it difficult to fall asleep. […] Polymyalgia rheumatica symptoms can interfere with your everyday activities, especially if the condition goes untreated. Without appropriate treatment, the pain and stiffness can severely reduce your mobility. You may eventually be unable to complete simple tasks on your own, such as bathing, getting dressed, and combing your hair. […] Theres no cure for polymyalgia rheumatica, but the condition often improves once you start treatment. In fact, it typically goes away after 2 to 6 years of treatment, and sometimes sooner.

• #20 Is Polymyalgia Rheumatica Related to Temporal Arteritis?

  https://www.webmd.com/arthritis/polymyalgia-rheumatica-temporal-arteritis

  Polymyalgia rheumatica (PMR) is an inflammatory condition that causes widespread pain, stiffness, or aching in the large muscle groups, especially around the shoulders, hips, lower back, neck, and thighs. […] PMR may cause pain and stiffness in your thigh but doesn’t usually affect your lower legs (as well as lower arms, hands, and feet). Pain and stiffness typically begin on one side of the body and eventually affect both sides. […] Symptoms of PMR tend to develop quickly. In addition to muscle pain, other symptoms may include: Stiffness around the shoulders and hips, especially in the morning and after resting, Weakness, Fatigue, Generally feeling ill, Mild fevers (occasionally), Weight loss. […] If left untreated, PMR can cause mobility issues and make it difficult for you to bathe or dress yourself or perform other daily activities, such as grooming, rising to a standing position, or getting in and out of cars.

• #21 Polymyalgia Rheumatica (PMR) Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/330815-clinical

  Patients with polymyalgia rheumatica (PMR) were often in good health prior to disease onset, which is abrupt in about 50% of patients. In most patients, symptoms appear first in the shoulder girdle. In the remainder, the hip or neck are involved at onset. At presentation, symptoms may be unilateral but they usually become bilateral within a few weeks. […] The symptoms include pain and stiffness of the shoulder and hip girdle. The stiffness may be so severe that the patient may have a great difficulty rising from a chair, turning over in bed, or raising the arms above shoulder height. Stiffness after periods of rest (gel phenomenon) as well as morning stiffness of more than 1 hour typically occurs. […] Muscle weakness is not a feature of PMR. However, this can be difficult to assess in the setting of pain, especially if symptoms are protracted and untreated, resulting in disuse atrophy.

• #21 Polymyalgia Rheumatica (PMR) Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/330815-clinical

  Systemic findings in more than 50% of patients are as follows: Low-grade fever and weight loss, malaise, fatigue, and depression, difficulty rising from bed in the morning, difficulty getting up from the toilet or out of a chair, difficulty completing daily life activities, high, spiking fevers (rare, should prompt evaluation for underlying infection, malignancy, or vasculitis). […] In later stages, disuse muscle atrophy with proximal muscle weakness may occur. Contractures of the shoulder capsule may lead to limitation of passive and active movements.

• #22 Polymyalgia Rheumatica Treatment – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/medicine/rheumatology-inflammation-immunity/arthritis-and-joint-diseases-center/polymyalgia-rheumatica

  Polymyalgia rheumatica (PMR) is an inflammatory condition that can cause aching and stiffness. It tends to affect the neck, shoulders, and hips. The aching and stiffness are usually worse in the morning or after long periods of inactivity. […] The main symptoms of polymyalgia rheumatica (PMR) are aching and stiffness about the upper arms, neck, and thighs. Symptoms tend to develop quickly, over days or weeks, occasionally even over night. Initially one part of the body can be affected more than the other but, over time, symptoms involve the upper arms and upper legs on both sides. Aching and stiffness are always worse in the morning and will tend to gradually improve as the day goes by. However, if there are prolonged periods of inactivity, stiffness will return. […] Stiffness can be so severe that there are night pains, problems getting dressed in the morning, (such as putting on a jacket or bending over to pull on socks and shoes), or difficulty getting up from a low chair. A classic symptom of PMR is difficulty raising the arms above the shoulders.

• #23 Polymyalgia rheumatica: An updated review | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/549

  Polymyalgia rheumatica should be suspected in older patients with bilateral shoulder and hip stiffness that is worse in the morning and improves with use. […] The cardinal feature of PMR is proximal girdle pain associated with restricted range of motion and stiffness. Shoulders are affected in up to 95% of cases; the neck and pelvic girdle can also be involved. Patients often report being unable to stand up from a chair, get out of bed without assistance, or lift their arms to comb their hair. […] Symptoms are characteristically worse in the morning and with inactivity. Morning stiffness tends to last an hour or more. Pain can also be strikingly severe at night and can affect sleep. […] Symptoms are related to inflammation of the articular and extra-articular structures, causing synovitis and bursitis of the shoulder, hip, and neck.

• #23 Polymyalgia rheumatica: An updated review | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/549

  Constitutional symptoms (ie, low-grade fever, anorexia, fatigue, and asthenia) are also common, occurring in up to half of patients. […] On physical examination, active range of motion is restricted due to pain, without actual weakness, while passive range of motion may be normal. […] Most established diagnostic criteria for PMR require either elevated erythrocyte sedimentation rate (ESR) (30 or 40 mm/h) or elevated C-reactive protein (CRP) (6 mg/dL), indicating an ongoing inflammatory process. […] Symptoms of PMR may be nonspecific, and many diseases present similarly. […] Rapid symptomatic improvement in response to low-dose prednisone (15 mg) historically was regarded as diagnostic for PMR. […] The mainstay of treatment of PMR is oral prednisone therapy. […] Treatment should have the goal of symptom remission, as well as improvement and eventual normalization of ESR and CRP levels.

• #24 How polymyalgia rheumatica can affect daily life | Top Doctors

  https://www.topdoctors.co.uk/medical-articles/polymyalgia-rheumatica-and-how-it-can-affect-daily-life

  Polymyalgia rheumatica (PMR) manifests in uncomfortable symptoms that if left untreated can potentially lead to disability – and, in rare cases, other serious complications such as vision loss. […] It’s a condition caused by inflammation in the body, that particularly affects the area where tendons attach to the bones around the shoulders, particularly the shoulders and the neck, and also around the pelvis. This causes very characteristic symptoms that people describe as feeling very stiff and achy, particularly first thing in the morning. They feel generally quite unwell with this condition. […] The symptoms are really very classic: Pain and stiffness are worse, first thing in the morning. […] If you ask someone, „When are the symptoms worse?”, they’ll always say in the morning. […] The pain has to have been there for at least two weeks. Stiffness in the morning tends to slightly ease as you get going, so it needs to be a minimum of 45 minutes. Although often it’s hours. Generally, people feel better as the day goes on, so towards the afternoon they say „I feel reasonably good, but the morning after I feel dreadful.”

• #25 Polymyalgia Rheumatica – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/vasculitis/polymyalgia-rheumatica

  Polymyalgia rheumatica is characterized by bilateral proximal aching of the shoulder and hip girdle muscles and the back (upper and lower) and neck muscles. Stiffness in the morning is typical and lasts 60 minutes. Shoulder symptoms reflect proximal bursitis (eg, subdeltoid, subacromial) and less often bicipital tenosynovitis or joint synovitis. Discomfort may awaken patients from sleep and is worse in the morning; occasionally it is severe enough to prevent patients from getting out of bed and from doing simple activities. The pain may make patients feel weak, but objective muscle weakness is not a feature of the disorder. […] Polymyalgia rheumatica affects adults 50 years, causing proximal myalgias and stiffness. […] It is present in 40 to 60% of patients with giant cell arteritis. […] Diagnose clinically, sometimes with supportive evidence of an elevated erythrocyte sedimentation rate and/or C-reactive protein along with a dramatic response to low to moderate doses of corticosteroids.

• #26 Polymyalgia Rheumatica | EdRheum

  https://www.edrheum.org/polymyalgia-rheumatica/

  PMR often comes on over a period of 1- 2 weeks; sometimes this can be associated with a flu-like illness prior to developing PMR. […] General symptoms include feeling generally unwell, low grade fever, fatigue, weight loss, anorexia, and low mood. […] Stiffness and muscle pain are usually worse in the morning, lasting 30 minutes or longer, or after periods of inactivity. […] Washing, dressing and getting out of bed and chairs are often difficult. […] Sleep is often affected. […] Rarely joint swelling can occur, however this is not associated with joint damage. […] Muscle weakness does not characteristically occur in PMR, examination usually shows normal muscle power and function, although limited by pain. […] Additional symptoms suggesting Giant Cell Arteritis include headache often affecting one side of the head, temporal and scalp tenderness, visual disturbance, and pain in the jaw or tongue on chewing.

• #27 Polymyalgia Rheumatica | Comprehensive Rheumatology

  https://www.comprehensiverheumatology.com/index.html@p=355.html

  Polymyalgia Rheumatica (PMR) is a relatively common inflammatory condition that causes aching pain and stiffness in the shoulders, hips, neck, and back. […] Patients with this condition usually have symmetrical pain in the shoulders, hips, neck, back, and torso, described as an aching pain and stiffness. It has been shown that not only are the joints involved, but the bursa around the joints, making the pain in the arms and thighs a referred pain. The pain is usually abrupt onset, worse in the morning (with morning stiffness lasting 1 hour), and usually limits normal daily activity, even simple activities such as putting on a shirt, getting to a standing position, and going up stairs, putting on shows or socks. The pain usually starts in the shoulders, and can be on one side, but usually becomes bilateral in a few weeks. Stiffness can occur after prolonged times of rest, known as the gel phenomenon. Patient can also have distal arthritis and even edema (swelling of the extremities)

• #28 Polymyalgia Rheumatica – Vasculitis Foundation

  https://vasculitisfoundation.org/education/vasculitis-types/polymyalgia-rheumatica/

  Polymyalgia rheumatica (PMR) is a rare inflammatory disease that affects older adults, causing widespread muscle pain and stiffness, especially around the shoulders and hips. Most people who develop PMR are in their 60s or 70s. PMR primarily affects the shoulders, neck, hips, lower back, and thighs, with muscle pain and stiffness that is worse in the morning. As a systemic disease (affecting the whole body), PMR also causes flu-like symptoms such as fatigue and fever. The symptoms of PMR can come on suddenly, over a period of days or weeks. […] The disease typically runs its course in one to five years. However, even with effective treatment, relapses can occur, so ongoing medical follow-up is essential. […] The symptoms of PMR often start suddenly and include pain, aching and stiffness in the shoulders, neck, upper arms, hips, lower back, and thighs. Symptoms are worse in the morning or after inactivity. Other common symptoms include low-grade fever, weight loss, loss of appetite, limited range of motion in joints, fatigue, and general flu-like feeling. […] People with PMR typically respond well to treatment and most eventually recover entirely from the disease within one to five years.

• #29 Polymyalgia Rheumatica

  https://www.nm.org/conditions-and-care-areas/rheumatology/vasculitis-center/Polymyalgia%20rheumatica

  Other symptoms can happen, such as swelling of the hands, wrists, feet, and ankles, numbness, tingling, or pain in the hand, wrist, or forearm, feeling of weakness, general feeling of being unwell, feeling tired, loss of appetite, weight loss, and low-grade fever. […] Some people with PMR also have a condition called giant cell arteritis, also called temporal arteritis or Horton arteritis. This is inflammation of blood vessels in the head, neck, and arms. This can narrow or block the blood vessels. It can cause problems from less blood flowing through those vessels. […] PMR often responds quickly to steroid medicine. This can help show if you have PMR. […] If untreated, PMR may go away on its own after several years. But symptoms will likely return.

• #30 Understanding Polymyalgia Rheumatica | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/understanding-polymyalgia-rheumatica

  The main symptoms of PMR are aching and stiffness of the shoulders, neck, and hips. The aching can extend to the upper arms and thighs. PMR often affects both sides of the body equally. Symptoms are often worse in the morning or after long periods of no activity. Movement can make the pain worse. […] The symptoms of PMR often affect the shoulders the most. You may have trouble raising your arms above the level of your shoulders. This can make it hard to get dressed. You may have trouble rolling over in bed, getting out of bed, and getting up from sitting. You may also have trouble sleeping because of your symptoms. […] Other symptoms can occur. These include: Swelling of the hands, wrists, feet, and ankles, Numbness, tingling, or pain in the hand, wrist, or forearm, Feeling of weakness, General feeling of being unwell, Feeling tired, Loss of appetite, Weight loss, Low-grade fever.

• #31 Polymyalgia rheumatica – Arthritis New Zealand

  https://www.arthritis.org.nz/forms-of-arthritis/polymyalgia-rheumatica/

  Polymyalgia rheumatica is a common inflammatory condition that causes painful muscles and joints. It is characterised by moderate to severe pain and stiffness, mainly in the shoulders, hips and thighs. It is often accompanied by feeling tired and unwell. […] The usual course of this disease is two to four years. Effective treatments are available and in most cases people recover completely. […] Pain and stiffness in the muscles and joints. […] Fatigue. […] Low-grade fever. […] Swollen joints. […] Weight loss. […] Depression. […] In about 15% of cases, polymyalgia rheumatica is associated with inflammation of the arteries in the head, known as temporal arteritis or giant cell arteritis (GCA). You should call your doctor immediately if you have any of these symptoms: severe headaches, jaw pain, blurred or double vision or tenderness of the scalp.

• #32 Polymyalgia Rheumatica: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/polymyalgia-rheumatica-pro

  The course and prognosis of PMR are very variable. Response to systemic corticosteroids is rapid and dramatic, usually within a few days, but treatment for 1-2 years is often required and some people may need low-dose corticosteroids for longer periods. Relapse is common but responds to restarting or increasing the dose of systemic corticosteroids.

• #33 Polymyalgia rheumatica – Wikipedia

  https://en.wikipedia.org/wiki/Polymyalgia_rheumatica

  About 20% of people who are diagnosed with polymyalgia rheumatica also have temporal arteritis (also called giant cell 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. […] Prednisone is the drug of choice for PMR, and treatment duration is frequently greater than one year. If the patient does not experience dramatic improvement after three days of 10-20 mg oral prednisone per day, the diagnosis should be reconsidered. Sometimes relief of symptoms occurs in only several hours.

• #34 Polymyalgia rheumatica – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/polymyalgia-rheumatica/diagnosis-treatment/drc-20376545

  Your diagnosis might change during treatment. Some people who are diagnosed with polymyalgia rheumatica are later diagnosed with rheumatoid arthritis or giant cell arteritis. […] Treatment most often involves medicines to help ease your symptoms. It’s common to get the condition again, called a relapse. […] A low dose of a corticosteroid you take by mouth, such as prednisone, most often treats polymyalgia rheumatica. You may feel rapid relief from pain and stiffness in 1 to 3 days. […] Many people with polymyalgia rheumatica need to have the corticosteroid treatment for 1 to 2 years or more. […] Long-term use of corticosteroids can result in serious side effects. These may include weight gain, bone thinning, high blood pressure, diabetes and cloudy areas on your eyes that can lead to vision loss, called cataracts. […] Polymyalgia rheumatica can cause you to be tired. Your body needs rest to recover from exercise and daily activities.

• #35 What is Polymyalgia Rheumatica? These Are the Signs You Could Have It – CreakyJoints Australia

  https://creakyjoints.org.au/education/polymyalgia-rheumatica-signs/

  There is a close link between polymyalgia rheumatica and a type of blood vessel inflammation called giant cell arteritis (GCA). Up to half of all people with GCA have PMR, while about 10 per cent of those with polymyalgia rheumatica will also have giant cell arteritis. Giant cell arteritis symptoms, like headache, jaw pain and vision changes, can be additional clues that someones muscle pain is related to polymyalgia rheumatica. […] Almost all patients with polymyalgia rheumatica are treated with corticosteroids to ease inflammation in the body. Patients with PMR respond extremely well to low doses of steroids, says Dr Loupasakis. Within the first three days they will notice improvement right away usually within 24 hours. Those with accompanying GCA generally need higher doses of steroids for the medication to take effect, he adds. […] Most people with PMR can finish up steroids and be symptom-free after a year or two, but some might need to stay on medication for up to five years.

• #36 Polymyalgia Rheumatica: A Severe, Self-Limiting Disease

  https://www.uspharmacist.com/article/polymyalgia-rheumatica-a-severe-self-limiting-disease

  Over time, disuse of muscle causes atrophy with proximal muscle weakness. In addition, contractures of the shoulder capsule may lead to limitations of passive and active movement. […] PMR is usually a self-limiting disease. If untreated, patients will have an impaired quality of life. With early diagnosis and correct therapy, patients have an excellent prognosis. The average length of disease is 3 years. However, exacerbations may occur if steroids are tapered too rapidly, and relapse is common, affecting up to 25% of all treated patients. […] Corticosteroids are considered the treatment of choice because they often cause complete or near-complete symptom resolution and reduction of the ESR to normal. However, they do not cure the disease. The low-dose corticosteroids used in PMR are almost certainly ineffective in the prevention of vasculitis progression.

• #37 Polymyalgia Rheumatica | CommonSpirit Health

  https://www.commonspirit.org/conditions-treatments/polymyalgia-rheumatica

  Symptoms often start suddenly and get worse without treatment. The most common symptoms are muscle pain and stiffness in the neck, shoulders, or hips. These symptoms are worse in the morning. And they affect both sides of the bodyfor example, both shoulders, not just one. […] Other symptoms may include: Tiredness and lack of energy. Fever. Weight loss. Swelling in the knees, wrists, or ankles. […] In some people, symptoms improve with treatment but then come back. This is called a relapse. It often occurs in the first 2 years of treatment or during the first year after steroid medicine is stopped. Your doctor will track your condition during this time. If you have a relapse, your doctor will increase your steroid dosage for a while. Then you can slowly lower it after your symptoms go away.

• #38 Polymyalgia rheumatica – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/polymyalgia-rheumatica/

  Polymyalgia rheumatica (PMR) is a common inflammatory disease that predominantly affects individuals 50 years of age and occurs more often in women than men. Patients typically present with acute pain and stiffness in the shoulder girdle, pelvic girdle, and/or neck, and constitutional symptoms. […] Constitutional symptoms: fever, weight loss, night sweats. […] Pain: acute onset, bilateral usually, worse at night. […] Morning stiffness (45 minutes). […] Muscular atrophy and weakness: not directly caused by PMR but resulting from reduced activity due to pain and stiffness. […] GCA and PMR share clinical features and may occur simultaneously. […] Glucocorticoids typically provide rapid symptomatic relief for PMR. […] Most patients adequately respond to glucocorticoid therapy. […] Relapses occur in up to 50% of patients. […] Up to 20% of patients have concomitant GCA. […] Factors associated with a worse prognosis: Female sex, High ESR at time of diagnosis, High doses of glucocorticoids.

• #39 Polymyalgia Rheumatica | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/polymyalgia-rheumatica/

  Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, particularly in the shoulders and hips. The condition develops most often in people ages 65 and older, and it might be related to another inflammatory disorder known as giant cell arteritis. […] Generally, symptoms affect both sides of the body and include: Pain in the shoulders that can spread to the neck or arms, Pain in the hips that can spread to the buttocks or thighs, Stiffness in affected areas that is worse in the morning or after inactivity, Reduced range of motion in affected areas. […] Other symptoms can include: Fatigue, Feeling of illness or discomfort, Fever, Loss of appetite, which can lead to weight loss. […] We typically monitor patients with polymyalgia rheumatica regularly because giant cell arteritis occurs in roughly 15 percent of patients with polymyalgia rheumatica. Giant cell arteritis is inflammation in the lining of the arteries that support the eyes, and it causes different symptoms. Rarely but devastating if untreated giant cell arteritis can result in stroke or blindness.

• #39 Polymyalgia Rheumatica | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/polymyalgia-rheumatica/

  The following symptoms suggest giant cell arteritis and should prompt immediate medical attention: Persistent, new, or unusual headaches, Jaw pain or tenderness, Vision loss, or blurred or double vision, Scalp tenderness. […] Polymyalgia rheumatica requires treatment with medications to relieve symptoms and manage the condition. Medications might need to be taken over a long period of time to help reduce the risk of relapse.

• #40 Polymyalgia Rheumatica | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/polymyalgia-rheumatica

  Other symptoms can happen, such as: swelling of the hands, wrists, feet, and ankles; numbness, tingling, or pain in the hand, wrist, or forearm; feeling of weakness; general feeling of being unwell; feeling tired; loss of appetite; weight loss; low-grade fever. […] PMR often responds quickly to steroid medicine. This can help show if you have PMR. […] Polymyalgia rheumatica doesn’t have any specific complications. But possible complications of giant cell arteritis may include blindness or stroke. […] If you have PMR, your symptoms will get better with treatment. Once you start feeling better, you can return to your normal activities. […] Common symptoms include aching and stiffness of the neck, shoulders, and hips. These symptoms are usually worse in the morning. […] Some people who develop PMR also develop giant cell arteritis.

• #41 Polymyalgia rheumatica: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000415.htm

  Polymyalgia rheumatica (PMR) is an inflammatory disorder. It involves pain and stiffness in the shoulders and often the hips. […] The most common symptom is pain and stiffness in both shoulder regions and the neck. The pain and stiffness are worse in the morning. This pain most often progresses to the hip regions. […] Fatigue is also present. People with this condition find it increasingly hard to get out of bed and to move around. […] For most people, PMR goes away with treatment after 1 to 2 years. You might be able to stop taking medicines after this point, but check with your provider first. […] For some people, symptoms return after they reduce or stop taking corticosteroids. In these cases, another medicine such as methotrexate or tocilizumab may be needed. […] More severe symptoms can make it harder for you to work or take care of yourself at home.

• #42 POLYMYALGIA RHEUMATICA | Sports Medicine Today

  https://www.sportsmedtoday.com/polymyalgia-rheumatica-va-233.htm

  Polymyalgia Rheumatica (PR) is an inflammatory condition that most often affects older patients. Typical symptoms include severe proximal muscle and joint stiffness/pain, most often in the shoulder girdle and hips. […] Initial symptoms include bilateral muscle and joint pain in the shoulder girdle and hips. Joint and muscle stiffness typically occur after long periods of rest. Stiffness tends to improve after 1-2 hours of activity. […] Pain will often limit range of motion of the shoulders and hips as well. […] PR has an excellent prognosis, often improving with a low dose of oral steroids, such as prednisone. Response to treatment is typically fast, with near resolution of symptoms within 24- 72 hours of treatment. […] Given the significant response to oral corticosteroids, most of those affected by Polymyalgia Rheumatica are able to return to sports/activities within a matter of days after starting treatment. Return is possible when pain and stiffness have resolved.

• #43 Polymyalgia Rheumatica Encinitas, CA – Diagnosis & Treatment Options

  https://www.seasiderheum.com/polymyalgia-rheumatica/

  Polymyalgia Rheumatica is an inflammatory syndrome that affects patients usually older than the age of 50. Patients will present with gradually worsening severe pain and stiffness in the proximal extremities (shoulder girdle and pelvic girdles area) symmetrically. The pain and stiffness are usually bilateral and worse with inactivity. […] Polymyalgia rheumatica is an inflammatory condition characterized clinically by aching and morning stiffness in the proximal upper and lower extremities. So, for example, pain and stiffness in the shoulders, the neck area, the hips, and the pelvic area. […] Polymyalgia rheumatica is almost exclusively seen in adults over the age of 50, and as these individuals age, the risk of developing the disease increases. […] Patients with polymyalgia are at increased risk to developing giant cell arteritis. Up to 30% of polymyalgia patients will develop giant cell arteritis. The symptoms associated with giant cell arteritis include, jaw pain, tongue pain, temporal headaches, scalp tenderness, stroke, and blindness. Giant cell arteritis symptoms are a medical emergency and should be treated immediately.

• #44 Polymyalgia rheumatica: clinical update

  https://www.racgp.org.au/afp/2014/june/polymyalgia-rheumatica

  Patients typically present with shoulder and hip girdle pain with pronounced stiffness. […] The hallmarks of PMR are shoulder and hip girdle pain with pronounced stiffness. The stiffness may be so profound that patients 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. […] PMR has an excellent prognosis if diagnosis is prompt and therapy adequate. […] Corticosteroids (prednisone or prednisolone) are considered the treatment of choice because they often cause complete or near-complete symptom resolution and reduction of the ESR to normal. […] Most patients require 12 years of therapy and slow tapering of the dose reduces relapses. […] PMR is usually self-limiting and patients who are not treated often feel unwell and have an impaired quality of life. PMR has an excellent prognosis with prompt diagnosis and adequate therapy.

• #45 Polymyalgia Rheumatica | Arthritis Foundation

  https://www.arthritis.org/diseases/polymyalgia-rheumatica

  The standard treatment for PMR has been an extended course of a corticosteroid, such as prednisone, because it quickly reduces pain and inflammation. The problem is that fully treating PMR can require taking steroids for two years or longer. Even then, symptoms may come back. […] Many people with PMR can stop medication after a year or two and remain symptom-free, but others may need life-long treatment to prevent relapses.

• #46 Polymyalgia rheumatica | healthdirect

  https://www.healthdirect.gov.au/polymyalgia-rheumatica

  Polymyalgia rheumatica is a condition usually affecting older adults. Symptoms of polymyalgia rheumatica include pain and stiffness in your shoulders, neck and hips. Polymyalgia rheumatica can cause: pain and stiffness in your shoulders, neck, buttocks and thighs; on both sides of your body […] pain that is worse in the morning or after not moving for a while, for example, after a long car ride or sitting for a long time […] difficulty with daily activities, such as lifting your arms up to put clothes on, bending over to put on shoes or getting up from a low chair. Each person experiences polymyalgia rheumatica differently. Symptoms can develop quickly or take a few days or weeks. They may be mild or severe. You may find that your symptoms improve quickly even after just a few days of starting your treatment. However, it can take from several months to up to 3 years for the condition to completely settle. For this reason, it’s usually recommended to continue treatment for 1 to 2 years. For some people, polymyalgia rheumatica goes away with treatment and doesn’t come back. For others, polymyalgia rheumatica affects them for life.

• #47 Polymyalgia rheumatica — Arthritis Australia

  https://arthritisaustralia.com.au/types-of-arthritis/polymyalgia-rheumatica/

  Polymyalgia rheumatica means pain in many muscles. It is a condition that causes inflammation of the joints and tissues around the joints. This causes muscles to feel painful and stiff, especially in the shoulder, neck and hip areas. The main symptoms are: muscle pain and stiffness in the upper arms, neck, buttocks and thighs on both sides of the body […] pain and stiffness worse in the morning, and after not moving, such as after a long car ride or sitting too long in one position […] difficulty sleeping and doing daily activities (for example, lifting the arms to put on a jacket, bending over to pull on shoes or getting up from a low chair) due to pain and stiffness. Symptoms usually come on quickly, over several days or weeks and sometimes even overnight. The good news is that the symptoms of polymyalgia rheumatica usually improve with treatment. In fact, most people find their symptoms improve dramatically within a few days of starting treatment. It usually takes between several months to three years for polymyalgia rheumatica to settle completely. Most people will need to continue treatment during this time to keep the symptoms under control. Polymyalgia rheumatica can return, particularly when you stop treatment, however this is rare if you have been free of symptoms for some time. The good news is that polymyalgia rheumatica does not cause permanent damage to the joints.

• #48 Polymyalgia Rheumatica – Harvard Health

  https://www.health.harvard.edu/a_to_z/polymyalgia-rheumatica-a-to-z

  Polymyalgia rheumatica is an inflammatory condition that causes pain in the joints and muscles of the lower back, thighs, hips, neck, shoulder and upper arms, and other parts of the body. […] Symptoms of polymyalgia rheumatica tend to start suddenly and may include: pain and stiffness in the shoulders, upper arms, neck, lower back, hips, thighs. The pain and stiffness tends to be worse in the morning. […] Without treatment, polymyalgia rheumatica sometimes goes away on its own over several years. With treatment, symptoms lessen or go away within days. […] Treatment may be required for years. But the outlook for people with polymyalgia rheumatica is excellent.

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