Polymyalgia Rheumatica

Data gathering

  • Red flags – headaches, visual changes, jaw pain, weight loss
  • Others – worse in the mornings, bilateral shoulder and hip pain
  • Examine – neck, shoulders, hips, temporal arteries


Clinical management

  • Investigations
    • Bloods – ESR
  • Explanation
    • PMR is a condition where there is irritation of the large muscles of the body leading to pain and stiffness – symptoms typically develop gradually – a steroid medicine helps ease symptoms and is needed for several months to years
  • Treatment
    • Prednisolone – 15mg OD, reduce slowly to maintenance dose of 5mg (over 1-2 years)
    • Steroid card – details dose, indication, informs drs to continue
    • Consider osteoporosis prophylaxis
  • Follow-up / Safety net
    • if headaches, visual changes – see dr urgently
    • see in 2 weeks for response to steroids


  • When starting steroids, check:
  • DM, mental health, BP, weight