Polymyalgia Rheumatica: Complete Guide to Symptoms, Causes, and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Polymyalgia Rheumatica: Complete Guide to Symptoms, Causes, and Treatment
Content current as of the latest published medical reference (August 18, 2026).
TL;DR
Polymyalgia rheumatica (PMR) is an inflammatory condition that causes pain and stiffness mainly in the shoulders and hips, most often worse in the morning. It mainly affects people over 65, most commonly between ages 70 and 80, and rarely affects people under 50. A low dose of oral corticosteroids usually brings rapid relief within one to three days, but treatment often lasts one to two years or more, and the condition is closely linked to a related disorder called giant cell arteritis.
Quick Answer
Polymyalgia rheumatica is an inflammatory condition that causes joint and muscle pain and stiffness, mainly in the shoulders and hips. Symptoms most often affect both sides of the body, begin quickly or over several days to weeks, and are worst in the morning or after inactivity. A low dose of an oral corticosteroid, such as prednisone, most often treats the condition, and people may feel rapid relief from pain and stiffness in one to three days. Many people need corticosteroid treatment for one to two years or more, and it's common to have a relapse.
What Is 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 (pol-e-my-AL-juh rue-MAT-ih-kuh) may begin quickly or come on over several days to weeks. Symptoms are most often worse in the morning.
Most people who get polymyalgia rheumatica are older than 65. It rarely affects people younger than 50.
This condition is related to another inflammatory condition called giant cell arteritis. Giant cell arteritis can cause headaches, vision troubles, jaw pain, and scalp tenderness. Some people have polymyalgia rheumatica and giant cell arteritis.
Answer nugget: Most people who get polymyalgia rheumatica are older than 65, and it most often happens between ages 70 and 80. It rarely affects people younger than 50.
What Are the Symptoms of Polymyalgia Rheumatica?
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; and 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, and being depressed.
Answer nugget: In polymyalgia rheumatica, stiffness in the affected areas is mainly worst in the morning or after not being active for a time, and the symptoms most often affect both sides of the body.
| Symptom | Description | |---|---| | Shoulder pain | Aches or pain in the shoulders, usually on both sides. | | Hip and pelvic pain | Aches or pain in the neck, upper arms, buttocks, hips, or thighs. | | Morning stiffness | Stiffness in affected areas, mainly in the morning or after not being active for a time. | | Reduced range of motion | Less range of motion in affected areas. | | Small-joint pain | Pain or stiffness in the wrists, elbows, or knees. | | Whole-body symptoms | Mild fever, tiredness, malaise, poor appetite, unexplained weight loss, or depression. |
What Causes Polymyalgia Rheumatica?
Experts don't know the cause of polymyalgia rheumatica. But genes may be part of the cause. Certain genes and gene changes might raise the risk of polymyalgia rheumatica, and researchers are studying other causes of the condition.
The Link to Giant Cell Arteritis
Polymyalgia rheumatica and another condition known as giant cell arteritis are alike in many ways. Many people who have one of these conditions also have symptoms of the other. Giant cell arteritis causes swelling and irritation, also called inflammation, in the lining of blood vessels called arteries. This inflammation often affects the arteries in the temples, but it also can affect other medium and large blood vessels, such as those to the heart.
Symptoms of giant cell arteritis include headaches, jaw pain, trouble seeing, and scalp tenderness. Sometimes, fever and weight loss may be the first symptoms. If not treated, giant cell arteritis can lead to a stroke or blindness.
Answer nugget: If not treated, giant cell arteritis can lead to a stroke or blindness, which is why people with polymyalgia rheumatica are watched for new headaches, jaw pain, vision changes, and scalp tenderness.
Who Is at Risk?
Risk factors for polymyalgia rheumatica include older age, being assigned female at birth, and white race.
Answer nugget: People assigned female at birth are about 2 to 3 times more likely to get polymyalgia rheumatica than people assigned male at birth.
When Should You See a Doctor?
See your healthcare professional if you have aches, pains, or stiffness that is new, keeps you from sleeping well, or makes it hard to do daily activities, such as getting dressed.
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, and getting dressed. These complications can affect your health, social life, physical activity, sleep, and well-being.
How Is Polymyalgia Rheumatica Diagnosed?
A physical exam and lab tests can help your healthcare professional find the cause of your pain and stiffness. The exam may include checking your joints and nervous system, called a neurological exam. During the exam, your healthcare professional might gently move your head and limbs to check their range of motion.
Your diagnosis might change during treatment. Some people who are diagnosed with polymyalgia rheumatica are later diagnosed with rheumatoid arthritis or giant cell arteritis.
| Test | How It Works | |---|---| | Blood tests | Besides checking your complete blood counts, your healthcare professional looks at two lab tests for signs of inflammation: erythrocyte sedimentation rate (sed rate) and C-reactive protein. Not everyone with the condition has high levels of these proteins in their blood, but most do. | | Ultrasound | An ultrasound can tell whether you have inflammation of the joints and soft tissues and can help in the diagnosis of polymyalgia rheumatica. | | MRI or PET scan | Some people have an MRI or a PET scan to look for other causes of joint pain. |
Watching for Giant Cell Arteritis
Your healthcare professional watches you for symptoms that can mean the onset of giant cell arteritis. Talk with your healthcare professional right away if you have any of the following: new headaches or headaches that don't go away, jaw pain or tenderness, blurred or double vision or vision loss, and a tender scalp.
To confirm a diagnosis of giant cell arteritis, you may have an ultrasound or a biopsy of an artery in one of your temples. A biopsy involves removing a small sample of the artery for study under a microscope, and it's done with a numbing medicine in the area where the artery is removed.
How Is Polymyalgia Rheumatica Treated?
Treatment most often involves medicines to help ease your symptoms. It's common to get the condition again, called a relapse.
Answer nugget: With a low dose of an oral corticosteroid such as prednisone, you may feel rapid relief from pain and stiffness in one to three days.
| Medicine | How It's Used | |---|---| | Corticosteroids (e.g., prednisone) | A low dose taken by mouth most often treats polymyalgia rheumatica. After 2 to 4 weeks, your healthcare professional might start to lower the dosage slowly. The goal is the lowest dose that keeps symptoms from coming back. Many people need corticosteroid treatment for 1 to 2 years or more. | | Calcium and vitamin D | Daily supplements to help prevent bone loss from corticosteroid treatment. Supplements of 1,000 to 1,200 milligrams of calcium and 600 to 800 international units of vitamin D are suggested for anyone taking corticosteroids for three months or more. | | Methotrexate (Trexall) | Taken by mouth to lower your immune system response. Suggested with corticosteroids in some people to lower the corticosteroid dose or for relapses. May be used early in treatment or later if symptoms return or corticosteroids don't work well enough. | | Sarilumab (Kevzara) | Approved by the FDA for people whose symptoms return. Works by blocking a substance in the body that causes inflammation. Taken as a shot every two weeks; may relieve symptoms with a lower dose of corticosteroids. |
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. Your healthcare team watches for side effects. You might need to change your dose or take medicines to manage corticosteroid treatment side effects.
Most people who take corticosteroids for polymyalgia rheumatica return to the level of activity they were at before they got the condition. But if you've had to limit your activity for a time, physical therapy may help. Talk with your healthcare team about whether physical therapy is a good choice for you.
What Self-Care Measures Help?
Healthcare professionals may suggest nonsteroidal anti-inflammatory medicines you get without a prescription to ease symptoms of polymyalgia rheumatica. These include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
Healthy-lifestyle choices can help you manage the side effects that corticosteroid treatment can cause. Eat a healthy diet — mainly fruits, vegetables, whole grains, and low-fat protein and dairy products. Limit salt, also called sodium, in your diet to prevent fluid buildup and high blood pressure. Exercise often, talking with your healthcare team about exercise to help you strengthen bones and muscles. Get enough rest, because polymyalgia rheumatica can cause you to be tired and your body needs rest to recover from exercise and daily activities. Use assistive devices — think about luggage and grocery carts, reaching aids, shower grab bars, and other devices to help make daily tasks easier.
Answer nugget: To help prevent bone loss from corticosteroid treatment, daily supplements of 1,000 to 1,200 milligrams of calcium and 600 to 800 international units of vitamin D are suggested for anyone taking corticosteroids for three months or more.
Even if you feel better soon after you start treatment, you may be distressed about having to take medicine daily that can cause such serious side effects. Ask your healthcare team what you can do to stay healthier while you take corticosteroids, and ask about local support groups in your area. Talking with others who are living with the same challenges might help.
How Can You Prepare for Your Appointment?
You'll likely start by seeing your main healthcare professional, who might send you to a specialist in joint and muscle conditions, called a rheumatologist. When you make the appointment, ask if there's anything you need to do before the appointment.
Make a list of your symptoms, including any that may not seem linked to the reason you scheduled the appointment, and when they began. Make a list of key personal information, including major stresses or recent life changes, and personal and family medical history. Make a list of any medicines, vitamins, and other supplements you take, including dosages. And write down questions to ask your healthcare team. Take a family member or friend with you, if you can, to help you keep what you learn.
Questions to ask include: What's the most likely cause of my symptoms? What are other possible causes? What tests do I need? Is this a condition likely to go away or to last? What treatments are there, and which do you suggest? I have other health conditions — how can I best manage them together? Do you have brochures or other printed material that I can have? What websites do you suggest?
Your healthcare team likely will ask you questions, such as: Where is your pain or stiffness? How would you rate your pain on a scale of 1 to 10? Are symptoms worse at certain times of the day or night? How long does stiffness last after you wake in the morning or after a period of not being active? Does the pain or stiffness limit your activities? Have you had new or bad headaches or jaw pain? Has your vision changed?
Conclusion
Polymyalgia rheumatica is an inflammatory condition of later life that announces itself through shoulder and hip pain and morning stiffness on both sides of the body. While the exact cause remains unknown, diagnosis rests on a physical exam plus inflammation markers such as the sed rate and C-reactive protein, and treatment — typically a low-dose oral corticosteroid — usually brings rapid relief within one to three days. Because treatment often runs one to two years or more and relapses are common, ongoing monitoring matters. Most importantly, the link to giant cell arteritis means watching for new headaches, jaw pain, vision changes, and scalp tenderness is essential, since untreated giant cell arteritis can lead to stroke or blindness.
Next step: If you're over 50 and have developed new pain and stiffness in your shoulders or hips — especially stiffness that is worst in the morning — book an appointment with your healthcare professional. If you've been diagnosed with polymyalgia rheumatica, report any new headaches, jaw pain, or vision changes right away, and ask your team how to protect your bones and manage corticosteroid side effects.
Frequently Asked Questions
What is polymyalgia rheumatica?
Polymyalgia rheumatica is an inflammatory condition that causes joint and muscle pain and stiffness, mainly in the shoulders and hips. Symptoms most often affect both sides of the body and are worst in the morning or after inactivity.
Who gets polymyalgia rheumatica?
Most people who get it are older than 65, most often between ages 70 and 80. It rarely affects people younger than 50. People assigned female at birth are about 2 to 3 times more likely to get it, and it's most common among white people from Scandinavia or northern Europe.
What causes it?
Experts don't know the exact cause, but genes may be part of it. Certain genes and gene changes might raise the risk, and researchers are studying other causes.
How is it diagnosed?
Diagnosis combines a physical exam — including a neurological exam and range-of-motion checks — with lab tests. Most people have elevated inflammation markers (erythrocyte sedimentation rate and C-reactive protein), and ultrasound can show inflammation of the joints and soft tissues.
How quickly does treatment work?
A low dose of an oral corticosteroid such as prednisone most often treats the condition, and people may feel rapid relief from pain and stiffness in one to three days.
How long does treatment last?
Many people need corticosteroid treatment for one to two years or more. After two to four weeks, the dosage is often lowered slowly, with the goal of the lowest dose that keeps symptoms from returning. Relapses are common.
What is the link to giant cell arteritis?
Polymyalgia rheumatica and giant cell arteritis are closely related, and many people with one have symptoms of the other. Giant cell arteritis inflames the lining of arteries, often in the temples, and if not treated can lead to a stroke or blindness.
How can side effects of long-term corticosteroids be managed?
Daily calcium (1,000-1,200 mg) and vitamin D (600-800 IU) supplements help prevent bone loss when corticosteroids are taken for three months or more. A healthy low-sodium diet, regular exercise, enough rest, and assistive devices also help, and your team may adjust your dose or add medicines such as methotrexate or sarilumab.
References
Polymyalgia Rheumatica — Symptoms & Causes: Mayo Clinic
Polymyalgia Rheumatica — Diagnosis & Treatment: Mayo Clinic
Journal of Internal Medicine — An Update on Polymyalgia Rheumatica (2022)
This article is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment of joint and muscle conditions. Content based on current clinical guidance and published medical sources; reviewed August 2026.
Health information, not medical advice. This article is for general education and is not a substitute for professional diagnosis or treatment. Always consult a qualified healthcare provider about your own health, and seek emergency care for urgent symptoms.
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