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Polymyalgia rheumatica (PMR)
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Polymyalgia rheumatica (PMR)

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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.

When to seek medical advice

See your doctor if you suspect you have PMR. Many people delay getting medical care because they think it's normal to have aching and stiffness as they grow older. But persistent pain is never normal. And because doctors can successfully treat PMR, you can be spared years of unnecessary discomfort and disability.

Screening and diagnosis

The symptoms of PMR are similar to those of other conditions, including rheumatoid arthritis and polymyositis — a disease that causes muscle inflammation and weakness. For that reason, your doctor will diagnose PMR only after ruling out other possible causes for your pain and stiffness.

To aid in the diagnosis, your doctor will interview you about your medical history and current symptoms and conduct a thorough physical exam. You're also likely to have one or more tests, including:

  • Sed rate. If your doctor suspects PMR, he or she will order a test that checks your erythrocyte sedimentation rate, commonly known as the sed rate. This test measures how quickly your red blood cells settle when placed in a test tube. Generally, the blood cells fall faster — that is, the sed rate increases — when inflammation is present. But because many conditions can cause inflammation in the body, including many forms of arthritis and other rheumatic diseases, an elevated sed rate alone can't confirm the presence of PMR.

  • Rheumatoid factor (RF). RF is an antibody — a protein made by the immune system — that's often present in the blood of people with rheumatoid arthritis, but not in the blood of people with PMR. For that reason, this test can help your doctor distinguish between the two conditions.

  • Other blood tests. Your doctor may also check the number of red blood cells and platelets (thrombocytes) in your blood. Platelets are colorless blood cells that help stop blood loss when you're injured. Most people with PMR have an unusually high number of these cells (thrombocytosis). On the other hand, many people with PMR have a lower number of red blood cells than normal and are often anemic.

If you receive a diagnosis of PMR, your doctor will check for a related condition called giant cell arteritis, which occurs in some people with PMR. Your symptoms and a sed rate test can help determine whether you have this disorder. The only way to confirm a diagnosis of giant cell arteritis, however, is by taking a small sample (biopsy) from the artery in your temple (temporal artery). The sample is then examined under a microscope in a laboratory.

But because PMR and giant cell arteritis are treated in much the same way, your doctor may simply choose to begin treatment, rather than perform a biopsy.

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