Polymyalgia: Causes, Risk Factors, Symptoms, Diagnosis and Treatment

It is an inflammatory disease that causes pain and muscle stiffness in the shoulders and hips.

The term myalgia refers to pain within the muscles . Polymyalgia causes pain and tension in the muscles.

Getting a correct diagnosis is key to ensuring proper treatment and symptom management, as there may be some confusion with another condition called fibromyalgia as the symptoms of both conditions are similar.

Although polymyalgia is eventually a disease that disappears completely, constant monitoring is important as it could trigger giant cell arteritis.

It is essential that the person with polymyalgia receive professional advice and guidance when dealing with chronic pain in order to effectively manage symptoms.

Causes of polymyalgia

The cause is uncertain, but polymyalgia is believed to develop due to a problem with the immune system.

This is an autoimmune disease in which the body’s immune system mistakenly attacks healthy connective tissues.

Risk factors for polymyalgia

Polymyalgia is a condition that is more common in women than men, and it usually occurs in the elderly. It is extremely rare in people under the age of 50.

Symptoms of polymyalgia


Polymyalgia does not show traditional signs of inflammation, although some recent research suggests that polymyalgia can also include inflammation.


The location of pain in people with polymyalgia is usually felt in the muscles of the neck, shoulders, back, and hips.

Mental health

Polymyalgia can cause depression related to living with a painful chronic condition.

Morning stiffness

This condition can make muscles and joints feel stiff. The main symptom is muscle stiffness in the morning that lasts more than 45 minutes.

Other symptoms

People with this condition may also have flu-like symptoms, headaches, high temperatures and sweating, extreme tiredness (fatigue), loss of appetite and consequently weight loss, in addition to having blurred vision.

About 15 percent of people with polymyalgia develop a potentially dangerous condition called giant cell arteritis, which is an inflammation of the arteries that supply the head.


Because of the wide differential diagnosis and possible disease states that mimic symptoms, clinicians evaluating polymyalgia patients must obtain a detailed history and perform a complete physical examination.

They should focus particularly on the musculoskeletal, vascular and neurological systems.

The doctor in the physical examination, will check what is the range of motion, strength and what are the painful areas of the patient.

Diagnosing polymyalgia can be difficult, the doctor will need to make sure that the patient has polymyalgia and not another condition, as many other conditions can also cause pain and stiffness, such as rheumatoid arthritis and fibromyalgia.

Your doctor may recommend:

  • Perform laboratory tests such as blood tests to look for signs of inflammation, the presence of muscle damage, and blood count problems.
  • Perform muscle and blood vessel biopsies (at the temple), to detect any damage.
  • Perform X-rays, MRIs, and ultrasound scans to obtain detailed images of the joints and soft tissues surrounding the joints.

Blood tests can usually diagnose polymyalgia. Most people with polymyalgia have elevated levels of inflammatory proteins in their blood.

Red blood cells can also show changes that are characteristic of inflammation.

Your doctor may also do other tests to rule out other inflammatory diseases, such as doing a biopsy or a blood test for rheumatoid factor. These tests are standard for people with polymyalgia, but not for people with other conditions.


Treatment for polymyalgia will be aimed at pain relief and corticosteroids are the treatment of choice for polymyalgia.

Corticosteroids are so effective in treating polymyalgia that if symptoms do not improve after use, polymyalgia might not be the correct diagnosis.

Polymyalgia patients will need to take long-term corticosteroid treatment (18 months to two years) to prevent symptoms from returning.

However this corticosteroid treatment can have serious side effects in this elderly population. Steroids can cause skin fragility, diabetes, osteoporosis, cognitive disorders, and muscle weakness.

Initially the doctor will prescribe a high dose of prednisolone, which will gradually decrease over time.

If the patient develops arteritis, high doses of corticosteroids may be necessary to control the condition and prevent vision loss.

Polymyalgia will eventually go away, but this can take up to five years. Proper nutrition, activity, rest, and medication regimens are important in managing the condition.

You should try to include in the diet foods that are rich in thiamine, pyridoxine (B6 and vitamins B1).

Pyridoxine is found in chicken meat, eggs, sprouted grains, curd, carrots, cabbage, bananas, seeds, cereals.

Thiamine is present in corn, brown rice, bran, potatoes, beans, lentils, black currants, asparagus, liver.

To prevent softening of the bones (Osteoporosis), patients are recommended mineral supplements containing calcium.

The diet of foods rich in calcium should include cheese, cottage cheese, almonds, celery, cabbage, lettuce, basil, sesame seeds, yogurt, kefir.

Once the stiffness subsides, a person can return to their daily activities, including exercise, as tolerated.