An Overview of Polymyalgia Rheumatica

The American College of Rheumatology (ACR), in collaboration with the European League Against Rheumatism (EULAR), released classification criteria for polymyalgia rheumatica in March 2012. The intent is to help identify patients with the condition. Prior to the release of the criteria, there were no well-established or well-tested criteria to identify patients with polymyalgia rheumatica.

Older woman rubbing shoulder in pain
Jose Luis Pelaez, Inc. / Blend Images / Getty Images


Polymyalgia rheumatica is a rheumatic condition with characteristic musculoskeletal pain and stiffness in the neck, shoulders, and hips that lasts at least four weeks. For most people, polymyalgia rheumatica develops gradually, although some can develop symptoms very quickly.

Besides musculoskeletal stiffness, symptoms of polymyalgia rheumatica may include systemic, flu-like symptoms such as fever, malaise, weakness, and weight loss.

Diagnosis and Identification

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 definitively diagnose polymyalgia rheumatica. Doctors sometimes order blood tests to detect elevated levels of inflammation (e.g., sedimentation rate or CRP), or to rule out other types of arthritis.

Under the classification criteria released by ACR and EULAR, a patient 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 criteria:

  • 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 (e.g., rheumatoid factor or anti-CCP antibodies)

The classification criteria were actually 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.


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 six months and two years.

If symptoms recur, which often happens, corticosteroids can be restarted. 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 typically resolve within one or two days. If corticosteroids do not resolve symptoms, the doctor is likely to consider another diagnosis.


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, but polymyalgia rheumatica occurs two to three times more frequently than giant cell arteritis. Both polymyalgia rheumatica and giant cell arteritis are classified as vasculitides (a group of conditions characterized by inflammation of the blood vessels).

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • "Questions and Answers about Polymyalgia Rheumatica and Giant Cell Arteritis." National Institute of Arthritis and Musculoskeletal and Skin Diseases. April 2010.

  • Dasgupta B. et al. "2012 Provisional Classification Criteria for PolymyalgiaRrheumatica: A European League Against Rheumatism/American College of Rheumatology collaborative initiative." Arthritis & Rheumatism. April 2012. doi:10.1136/annrheumdis-2011-200329

  • Docken, MD., WP. "Polymyalgia Rheumatica." American College of Rheumatology. Updated August 2009.

  • Klippel J. et al. "Primer on the Rheumatic Diseases. Polymyalgia Rheumatica." Pages 404-406. Thirteenth Edition. Arthritis Foundation.