Polymyalgia rheumatica (PMR), an inflammatory disorder that causes widespread muscle aching and stiffness, especially in your neck, shoulders, thighs and hips.

Although some people develop these symptoms gradually, PMR can literally appear overnight. People with the condition may go to bed feeling fine, only to awaken in pain the next morning.

Just what triggers PMR isn't known, but the cause may be a problem with the immune system, perhaps involving both genetic and environmental factors. Aging also appears to play a role - the disease almost always occurs in people age 50 and older.

PMR usually goes away on its own in a year or two - often as mysteriously as it came. But you don't have to endure the pain and disabling effects of the disease for months or years. High doses of aspirin and other anti-inflammatory medications can sometimes ease mild symptoms. Severe pain responds to the powerful corticosteroid drug prednisone, often within 24 to 48 hours.

Signs and symptoms

PMR causes moderate to severe aching and stiffness in the muscles in your hips, thighs, shoulders, upper arms and neck. Most people have pain in at least two of these areas. Initially, you may have pain on just one side of your body, but as the disease progresses, symptoms are likely to occur on both sides.

Stiffness is usually worse in the morning and may make it hard to get out of bed. In fact, you may spend your first waking hours just trying to move without too much pain. The effort can leave you feeling exhausted for the rest of the day. Pain may also be severe enough to wake you during the night.

Sometimes the aching and stiffness of PMR develop suddenly. In other cases, symptoms appear more gradually. PMR can cause other signs and symptoms including:

• Fatigue

• Giant cell arteritis

• Weight loss

• Slight fever

Fifteen percent to 25 percent of people with PMR have a related condition called giant cell arteritis, which causes the arteries in the temples and sometimes in the neck and arms to become swollen and inflamed.

Causes

PMR is an arthritic syndrome that causes your muscles to feel achy and stiff due to mild inflammation in large joints, such as your shoulders, hips and knees. In general, the inflammation isn't as severe as that in inflammatory types of arthritis, such as rheumatoid arthritis.

In PMR, inflammation occurs when white blood cells — which normally protect your body from invading viruses and bacteria — attack the lining of your joints (synovium). Just what causes the immune system to react this way isn't known.

• Giant cell arteritis

• Rheumatoid arthritis

Risk factors

Although the exact causes of PMR aren't known, certain factors may increase your risk of developing the disease, including:

• Age. PMR affects older adults almost exclusively — the average age at onset of the disease is 70.

• Sex. Women are two times more likely to develop the condition than men are.

• Race. Although PMR can affect people of any race, the vast majority are white. People of Northern European and Scandinavian origin are particularly at risk.

• Other health conditions. Also at risk are people with giant cell arteritis, a condition that causes the arteries in your temples to become swollen and inflamed. As many as 50 percent of people with giant cell arteritis also have PMR.

• Giant cell arteritis

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