Polymyalgia Rheumatica And Giant Cell Arteritis: Symptoms

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Symptoms

Polymyalgia rheumatica

Symptoms of polymyalgia rheumatica (PMR) often occur suddenly and get worse without treatment. Symptoms are noticeable for at least a month before the condition is diagnosed. Typical polymyalgia rheumatica symptoms include pain and morning stiffness in the:¹

• Shoulder (in up to 95% of cases).
• Neck (in up to 70% of cases).
• Pelvic and hip region (in up to 70% of cases).

These symptoms are caused by inflammation of joints, tendons, and bursae of the hip and shoulder regions. The pain affects both sides of the body. For example, both shoulders will usually be painful, not just one. Usually, both the shoulder and hip areas are affected.

Other symptoms of polymyalgia rheumatica may include:

• Feeling tired and having no energy or strength (fatigue).
• Weight loss.
• Low fever.
• Depression.
• Swelling of the knees, wrists, or ankles.

Giant cell arteritis

Symptoms of giant cell arteritis (GCA) can develop gradually or suddenly. They require immediate treatment.

Symptoms of giant cell arteritis may include:

• Headache, often near the temple or around the eye (temporal headache). Headaches are a symptom for up to 80% of people who are examined for giant cell arteritis.³ The headache may begin as a dull, throbbing pain on one side of the head around the eye or near the temple. Occasionally the pain may feel like a stabbing or burning sensation.
• Vision problems in up to half of cases. These problems may come on quickly and be temporary, but sometimes they do not go away. Examples include:³
  • Brief loss of vision or partial loss, lasting seconds to minutes.
  • Blurry or double vision.
  • Blindness.
  • Patches of poor vision surrounded by normal vision.
  • Decreased sharpness (acuity) of vision or focus.
• Tenderness on the side of the head (temple) or scalp. The blood vessel on the temple may also look swollen and its pulse may be decreased or absent. You may notice tenderness when you wear your glasses or comb your hair.
• Pain, aching, weakness, or cramping (claudication) of the tongue or jaw, especially when you chew food or talk for long periods of time.

Other uncommon symptoms of giant cell arteritis may include cough, hoarseness, chest pain, and arm weakness or cramps.

Some people with giant cell arteritis do not have the typical symptoms of headache, jaw pain, and vision problems. About half of people with giant cell arteritis will also have symptoms of polymyalgia rheumatica.^{1 2}

Untreated giant cell arteritis can cause narrowing (constriction) of some of the arteries in the skull or head , reducing blood flow. As a result, a person with untreated giant cell arteritis is at greater risk of blindness, stroke, or mini-strokes (transient ischemic attacks, or TIAs).

Conditions with symptoms similar to polymyalgia rheumatica or giant cell arteritis include osteoarthritis, rheumatoid arthritis, fibromyalgia, and lupus.

Last updated:	May 08, 2007
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	E. Gregory Thompson, MD - Internal Medicine, Stanford M. Shoor, MD - Rheumatology
Editors:	Kathe Gallagher, MSW, Pat Truman, MATC