Polymyalgia Rheumatica: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Polymyalgia Rheumatica?
A rheumatologist, a doctor who treats diseases of the joints, muscles, and immune system, usually treats polymyalgia rheumatica. A primary care doctor often notices the problem first. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is polymyalgia rheumatica?
Polymyalgia rheumatica (PMR) is a condition that causes pain, stiffness, and inflammation in the muscles around the shoulders, neck, and hips. Inflammation means swelling and irritation in the body.
PMR is most common in women. It almost always occurs in people over 50. In some cases, it develops overnight. In others, it is gradual.
Symptoms
The main symptom is muscle stiffness in the morning that lasts longer than 45 minutes. Stiffness after resting is also a main symptom. Other symptoms may include:
- Extreme tiredness.
- Loss of appetite.
- Weight loss.
- Depression.
- Fever.
- Weakness.
Causes and who gets it
The cause of PMR is unknown. A mix of genetic and environmental factors is thought to be responsible. Genetic means passed down in families. Environmental means things around you.
PMR is linked to age. Most people who are diagnosed are over 65, and it is very rare in people younger than 50. It is also more common in women than in men.
PMR sometimes occurs along with giant cell arteritis. This is a condition that causes swelling of the arteries in your head. Arteries are the blood vessels that carry blood from the heart. Up to 1 in 5 people with PMR develop giant cell arteritis.
How doctors diagnose it
There is no specific test for PMR. Your doctor will use your medical history, your symptoms, and a physical exam to make the diagnosis. Lab tests for inflammation may help confirm the diagnosis.
Diagnosis can be hard. The symptoms are similar to those of many other conditions, including rheumatoid arthritis, a long-term joint disease. Doctors need to rule out these other conditions before they diagnose PMR.
Treatment
A steroid medicine called prednisolone is the main treatment for PMR, says the NHS. MedlinePlus says doctors often prescribe prednisone, a steroid medicine. Steroids calm inflammation.
You may start with a moderate dose. Your doctor will lower it gradually over time. Your symptoms should improve within a few days of starting treatment. Most people need steroid treatment for 12 months to 2 years to keep their symptoms from coming back.
Prednisolone does not cure PMR, but it can help relieve the symptoms. Some people also take an immunosuppressant medicine such as methotrexate. This kind of medicine holds back the immune system. It may help people who have frequent relapses or do not respond to normal steroid treatment. A relapse means the symptoms come back.
Steroids can cause side effects. These include increased appetite that often leads to weight gain, high blood pressure, weakening of the bones (osteoporosis), stomach ulcers, and a higher risk of infection.
About 1 in 20 people have changes in their mental state when they take prednisolone. Contact your doctor as soon as possible if this happens. If you are thinking about harming yourself, call or text 988 (the Suicide and Crisis Lifeline) right away.
Do not suddenly stop taking steroid medicine unless your doctor tells you it is safe. Stopping suddenly can make you very unwell. You will have regular follow-up appointments, and you may have blood tests to check the level of inflammation in your body.
When to see a doctor
See a doctor if you have pain and stiffness for more than a week.
Call 911 or go to the emergency room if you have double vision, loss of vision in one or both eyes, or a sudden change in vision. Contact your doctor right away if you have a new or frequent headache that usually starts suddenly, or pain in the jaw muscles or tongue when eating or talking. These can be signs of giant cell arteritis. It can lead to serious problems like stroke or blindness if it is not treated quickly.
Contact your doctor if your PMR symptoms return at any point during treatment.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A doctor in one of these practices can talk through your symptoms, order blood tests, and refer you to a rheumatologist. They can also help you keep up with follow-up visits while you take steroid medicine.
Common questions
Is polymyalgia rheumatica the same as giant cell arteritis?
No, they are different conditions, but they can occur together. MedlinePlus says PMR sometimes occurs along with giant cell arteritis. Giant cell arteritis needs care right away because it can lead to stroke or blindness if it is not treated quickly.
How long does treatment for polymyalgia rheumatica last?
Most people need steroid treatment for 12 months to 2 years to keep their symptoms from coming back. Your doctor will lower the dose gradually and will check on you at regular follow-up visits.
Can polymyalgia rheumatica come back?
Yes, there is a chance it will return after treatment stops. This is called a relapse. Contact your doctor if your symptoms return during any part of your treatment.
Is there a test for polymyalgia rheumatica?
No, there is no specific test for PMR. Your doctor will use your medical history, your symptoms, and a physical exam. Lab tests for inflammation may help confirm the diagnosis.
Sources
- MedlinePlus - Polymyalgia Rheumatica
- NHS - Polymyalgia rheumatica
- NHS - Polymyalgia rheumatica: Treatment
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
