Karen McPhail, RN, MSN
Is it Polymyalgia Rheumatica? Frequently missed in Older Adults

In my clinical practice I see a wide range of patients and a variety of conditions. Polymyalgia rheumatica (PMR) is a fairly common, yet often missed, cause of impaired functionality through widespread discomfort, aching, and stiffness that affects adults over the age of 50. Although immediate in terms of symptom onset, because polymyalgia rheumatica causes generalized and sometimes somewhat vague symptoms of discomfort without swollen joints, it may be easily dismissed, hard to recognize and at times overlooked in older adults (https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Polymyalgia-Rheumatica).
Often times clinicians simply dismiss what they feel are common aches and pains as a part of aging and arthritis.
Here are some common symptoms to watch for:
Stiffness, discomfort and achiness in neck, shoulders, upper arms, lower back and thighs that is worse in the morning (or during the night) and improves throughout the day with movement.
Achiness and stiffness that occurs in conjunction with inactivity, such as prolonged sitting, a long car ride - may cause stiffness to return.
Discomfort and stiffness that results in - Disturbed sleep, difficulty dressing or performing aspects of daily living, or with transfers.
Pain is not relieved by Nonsteroidal anti-inflammatory drugs, such as ibuprofen, (Advil, Motrin) and naproxen (Naprosyn, Aleve).
If you or your loved one have these symptoms some simple diagnostic testing (lab work) can be done to help in diagnosing and pinpointing treatment. If PMR is determined, a trial of low-dose corticosteroids (10-15 mg per day) will be prescribed and is usually effective. if you develop a headache or changes in vision along with these symptoms please ensure that this is reported timely to your health provider as this can be an indication of a more serious, yet treatable condition called Giant cell arteritis.
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