Updated December 13, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

The American College of Rheumatology (ACR), in collaboration with the European League Against Rheumatism (EULAR), released classification criteria for polymyalgia rheumatica on March 2, 2012. The criteria should help identify patients with the condition. Prior to this, there was not well-established or well-tested criteria to identify patients with polymyalgia rheumatica.

Symptoms of Polymyalgia Rheumatica

Polymyalgia rheumatica is a rheumatic condition with characteristic musculoskeletal pain and stiffness in the neck, shoulders, and hips that lasts at least 4 weeks.

For most people, polymyalgia rheumatica develops gradually, although some can develop symptoms very quickly. Besides musculoskeletal stiffness, symptoms of polmyalgia rheumatica can include systemic, flu-like symptoms (such as fever, malaise, weakness, and weight loss).

Diagnosing/Identifying Polymyalgia Rheumatica

The diagnosis of polymyalgia rheumatica has been based on the patient's medical history, clinical signs and symptoms, and a physical examination. There is no single blood test to definitely diagnose polymyalgia rheumatica. Doctors sometimes order blood tests to detect elevated inflammation (sedimentation rate or CRP), or to rule out other types of arthritis.

Under the classification criteria released by ACR and EULAR, a patients may be classified as having polymyalgia rheumatica if they are 50 years old or older, have bilateral shoulder aching, and abnormal blood CRP or sedimentation rate, plus certain combinations of the following:

• Morning stiffness lasting 45 minutes or more
• New onset hip pain or limited range of motion

• No swelling in small joints of hands and feet
• No positive blood tests for rheumatoid arthritis (rheumatoid factor or anti-CCP antibodies)

The classification criteria was not created to be a diagnostic protocol, but rather to help with the selection of patients for clinical trials and to develop new therapies to treat polymyalgia rheumatica.

Treatment of Polymyalgia Rheumatica

Polymyalgia rheumatica is treated with a low dose of corticosteroid medication. Doctors prescribe and adjust the dose of steroids (usually prednisone) to achieve the lowest effective dose. Usually, stiffness associated with polymyalgia rheumatica is relieved quickly. Most polymyalgia rheumatica patients are able to stop corticosteroid medications between 6 months and 2 years. If symptoms recur, which often happens, corticosteroids can be re-started. Nonsteroidal anti-inflammatory medications (NSAIDs) can also be used to treat polymyalgia rheumatica but usually, when taken alone, they are not enough to control symptoms.

Without treatment, polymyalgia rheumatica symptoms are likely to persist for months or years. With corticosteroid treatment, however, symptoms resolve within one or two days. If corticosteroids do not resolve symptoms, the doctor is likely to consider another diagnosis.

Prevalence of Polymyalgia Rheumatica and Statistics

Women who are Caucasian and over age 50 have the highest risk of developing polymyalgia rheumatica or giant cell arteritis (a related condition). In the United States, it is estimated that 700 per 100,000 people over 50 in the general population develop polymyalgia. It is very rare for someone under 50 years old to develop polymyalgia rheumatica.

Polymyalgia rheumatica affects the same patient population as giant cell arteritis (GCA), but polymyalgia rheumatica occurs two to three times more frequently than GCA. Both polymyalgia rheumatica and giant cell arteritis are classified as vasculitides.

<sub>Sources:

2012 Provisional classification criteria for polymyalgia rheumatica: A European League Against Rheumatism/American College of Rheumatology collaborative initiative. Dasgupta B. et al. Arthritis & Rheumatism. April 2012.
http://onlinelibrary.wiley.com/doi/10.1002/art.34356/abstract;jsessionid=086C7B667EF117296B81F805769A88BC.d02t03

Questions and Answers about Polymyalgia Rheumatica and Giant Cell Arteritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. April 2010.
http://www.niams.nih.gov/health_info/polymyalgia/

Polymyalgia Rheumatica. American College of Rheumatology. William P. Docken, MD. Updated August 2009.
http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/polymyalgiarheumatica.asp

Primer on the Rheumatic Diseases. Polymyalgia Rheumatica. Pages 404-406. Klippel J. et al. Thirteenth Edition. Published by Arthritis Foundation.</sub>