Introduction to polymyalgia rheumatica
Polymyalgia rheumatica is an inflammatory condition characterised by bilateral aching and stiffness of the shoulders and hip-girdle area caused by low-grade synovitis. Morning stiffness is the hallmark of the disease. Patients complain of being unable to turn over in bed and of great difficulty getting out of bed. The stiffness tends to improve after a hot shower, and with activity. The onset of symptoms can be sudden or gradual. It occurs almost exclusively in people older than 50 years, with the incidence increasing with age; it is more common in females than males.
About 15% of patients with polymyalgia rheumatica also have giant cell arteritis. Urgently refer patients with suspected giant cell arteritis to a specialist, including patients with polymyalgia rheumatica who have jaw claudication, severe headache, visual symptoms, scalp tenderness or malaise, because these are classic symptoms of giant cell arteritis.