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Polymyalgia Rheumatica: When Devastating Stiffness Takes Over Your Life

by — 2015-11-09 in Musculoskeletal Issues

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Polymyalgia rheumatica is an inflammatory condition that causes devastating pain and stiffness, but it's surprisingly difficult to diagnose. With the right treatment, however, your quality of life can improve drastically and immediately.

Edith, a woman in her 70s, had lived with chronic pain for years — it started with aching shoulders, a pain that soon progressed to her neck, hips, thighs, lower back, and even upper arms. Her mobility declined fast, to the point that she felt stiff when she woke up, couldn't hold a pen to write in her journal any more, and her trouble getting her shoes on. Edith's days became dominated by pain, which didn't subside even with over the counter painkillers. 

Then, there was the constant feeling that she was coming down with a flu. Fever, fatigue, weakness, not feeling like eating, and of course the accompanying weight loss. In the end, it got so bad that Edith, one of the elders I care for, couldn't get out of bed at all. She'd just cry, wondering if life was still worth living.

Worst of all? Edith had no idea what was wrong with her. Her doctors could not give her a diagnosis. 

What Is Polymyalgia Rheumatica?

A rarely talked-about inflammatory disorder, polymyalgia rheumatica almost always strikes people over 65 years old — and often suddenly, over a period of days or weeks. Once you reach your sixth decade, you often find you already have all kinds of aches and pains, and often also diagnosed or undiagnosed underlying medical conditions. The symptoms of stiffness, pain, and limited movement may be interpreted as being a normal part of the aging process — but they are not. 

The stiffness people with polymyalgia rheumatica experience is always worse first thing in the morning, yet the pain they wake up with may cause them to avoid being active and mobile, once again contributing to further stiffness. People with polymyalgia rheumatica will typically experience the following symptoms:

  • Stiffness and pain in very varied parts of the body, such as the shoulders, neck, lower back, upper arms, buttocks, thighs, wrists, and ankles. 
  • Increased stiffness after sleep or after other prolonged periods of physical inactivity.
  • A shortened range of motion, including difficulties getting dressed, using tools such as pens or knives, and getting up front a sitting or laying position.
  • Sleep difficulties. 
  • Depression. 
  • Sometimes fever.
  • A feeling of general weakness and malaise. 
  • A loss of appetite and resultant weight loss.

What  Causes Polymyalgia Rheumatica?

Nobody knows, as of yet. But, and you'll have heard this story before, both genetic and environmental factors are thought to be involved in its onset. Though the cause of PMR isn't yet clear, we do know about some definite risk factors. First off, polymyalgia rheumatica is almost always a disease that affects older people, those over 65. It is almost never seen in people under 50. Women and people of North European ethnic origin are also much more likely to develop PMR.
Another thing you need to know about if you suspect you may have polymyalgia rheumatica is that there's another disease that seems to be closely linked to PMR, to the point that some medical professionals believe them to be the same disease. This disease is called giant cell arteritis. One in five PMR patients will show signs of giant cell arteritis, while about half of those diagnosed with giant cell arteritis will have symptoms of PMR. In giant cell arteritis, the arteries become inflammed and patients experience headaches, jaw pain, and vision problems. If left untreated, giant cell arteritis can lead to a stroke and also blindness. Because giant cell arteritis is dangerous, you need to inform your doctor right away if these symptoms sound familiar to you.
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