Last updated 18/03/2022 by The pain clinics - Interdisciplinary Health

What You Should Know About Polymyalgia Rheumatism (PMR)

Polymyalgia rheumatism is an inflammatory-related rheumatic diagnosis.

The disorder is characterized by, among other things, extensive pain and pain in the shoulders, hips and neck - as well as associated morning stiffness. The pain and stiffness are often worst on the mornings.

No gold in the mouth there. Rather gray.

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Classic symptoms of Polymyalgia Rheumatism include:

• General feeling of weakness

• Mild fever and exhaustion

• Pain and hypersensitivity in the shoulders, hips and neck

• Morning stiffness

Tips for Polymyalgia Rheumatism

Polymyalgia rheumatica is a diagnosis that is often characterized by a high level of muscle tension in the upper back, but also in the lower back and pelvis. When our patients with PMR ask for advice on self-measures, we often have a distinctive focus on relaxation. acupressure mat and use of massage balls (the links open in a new browser window) with the right use can help you reduce overactivity in the muscles and have a soothing effect.

Polymyalgia Rheumatism and Rheumatic Arthritis

Earlier, it was thought that polymyalgia rheumatism was a form of rheumatic arthritis among the elderly population. That's wrong - they are two completely separate diagnoses.

The most significant difference is that PMR does not lead to the destruction of cartilage and joint surfaces - unlike rheumatoid arthritis. The diagnosis also does not, normally, affect the hands, wrists, knees and feet. The condition is also not permanent - but can persist for up to 7 years.

Who Is Affected by Polymyalgia Revmatika?

Polymyalgia rheumatism is the most common inflammatory rheumatic diagnosis affecting those over 50 years of age. The risk of developing the disease increases with age - and the average age of those affected is around 75 years (1).

Women have a 2 to 3 times higher risk of developing the diagnosis. In other words, it is most common that it affects older women.

How Does Polymyalgia Rheumatism Give You Joint Pain?

An MRI examination will reveal a detailed picture of what is going on in and around your joints. In PMR, you will see inflammation in the synovial membrane - which is found in mucous sacs, joints and tendons. Increased fluid and inflammatory reactions provide the basis for the pain.

The exact cause of inflammation due to PMR is still not fully understood. Research indicates that genetics, epigenetics, infection (viruses and bacteria) can play a central role in why one develops the diagnosis (2).

Polymyalgia Rheumatism and Inflammation

PMR thus gives more inflammatory reactions than usual. The most common forms of inflammation associated with polymyalgia rheumatica are bursitis (inflammation of the mucous membranes), synovitis (arthritis) and tenosynovitis (inflammation of the outer layer of the tendons - the tendon).

Bursitis (bursa inflammation)

Polymyalgia rheumatism gives more frequent occurrence of bursitis in the shoulders and hips. Bursitis is thus an inflammation of a mucous sac - an anatomically fluid-filled structure that ensures smooth movement between bones and nearby soft tissue. In inflammation, this is filled with extra fluid that causes pain.

Synovitis (Arthritis)

Shoulder joints and hip joints may be affected by synovitis. This means that the synovial membrane becomes inflamed and we get fluid formation inside the membrane - which causes joint pain, heat development and reddish skin.

tenosynovitis

When the outer layer of the membrane around a tendon becomes inflamed, this is called tenosynovitis. This occurs more frequently among those with PMR - and one of the most common versions is Dequervain's Tenosynovitis of the wrists.

Polymyalgia Rheumatism and Exercise

Finding the right exercises and training for you with PMR can be difficult. But it is crucial that you continue to keep moving to stimulate blood circulation and to soften the aching joints and muscles.

In the video below you will see a training program for those with polymyalgia rheumatism developed by chiropractor and rehabilitation therapist Alexander Andorff. This is a program that is divided into 3 - neck, shoulder and hips, as it is most often these areas that are most affected by PMR.

Feel free to subscribe to our YouTube channel for free (click here) for free exercise tips, exercise programs and health knowledge. Welcome to the family you must be!

Recommended Self-Measures against Polymyalgia Rheumatism

Due to the fact that the diagnosis is so clearly linked to increased tension and pain in the upper back, as well as the shoulders, but also in the pelvis and hips, we recommend self-measures that can reduce muscle pain. acupressure mat (the link opens in a new window) is an own measure that many feel gives them relaxation and relief against tense muscles. The mat also has its own neck part which makes it easier to work towards muscle tension in the neck. Another good measure might be to roll on massage ball - especially for the muscles inside the shoulder blades and in the neck transition.

(In the picture you see one acupressure mat in use. Click on the image or link here to read more about what is also called trigger point mat.)

Other Recommended Self-Help for Rheumatic and Chronic Pain

• Compression Noise (such as compression socks that contribute to increased blood circulation to sore muscles or specially adapted compression gloves og socks against rheumatic symptoms in the hands and feet)

• Toe pullers (several types of rheumatism can cause bent toes - for example hammer toes or hallux valgus (bent big toe) - toe pullers can help relieve these)
• Mini tapes (many with rheumatic and chronic pain feel that it is easier to train with custom elastics)
• Trigger point Balls (self-help to work the muscles on a daily basis)
• Arnica cream or heat conditioner (some patients with PMR feel that arnica cream or balm may be soothing)

Will my Polymyalgia Rheumatism Continue to deteriorate over the years?

The PMR can actually go by itself. This means that the condition is not permanent, but that it is still long-lasting. The pain and symptoms caused by PMR are usually significant and will often need treatment. PMR normally lasts for two years, but can also last for up to seven years. Unfortunately, it is also possible to be affected by the condition again - even several years after you last had it.

Treatment of Polymyalgia Rheumatism

The treatment consists both of medications to relieve inflammation, but also of physical treatment to relieve pain in the muscles and joints. Drug treatment includes corticosteroids - such as cortisone tablets. Common physical treatment methods are musculoskeletal laser therapy, massage and joint mobilization - for example with a physiotherapist or chiropractor. Many patients also use self-measures and self-treatment (as shown above). For example, compression supports and trigger point balls.

Polymyalgia Rheumatism and Glandular Arthritis

PMR significantly increases the risk of developing giant cell arthritis - also known as temporal arthritis. This is a dangerous condition that can cause serious complications in the form of vision loss and higher risk of stroke. The condition causes inflammation in the blood vessels that go to the scalp and eyes. Between 9 and 20 percent of those with PMR develop giant cell arthritis - which requires drug treatment.

Polymyalgia Rheumatism Support Groups

Join the Facebook group «Rheumatism and Chronic Pain - Norway: Research and news» (Press here) for the latest updates on research and media writing about rheumatic and chronic disorders. Here, members can also get help and support - at all times of the day - through the exchange of their own experiences and advice.

Share Feel free to Support those with Rheumatism

We kindly ask you to share this article in social media or via your blog(please link directly to the article). We are also happy to exchange link exchanges with relevant websites. Understanding, general knowledge and increased focus are the first steps towards a better everyday life for those with chronic pain diagnoses.