We hear all the time that it's hard to diagnose fibromyalgia because it's similar to so many other conditions. One of those similar conditions is polymyalgia rheumatica (PR).
It's possible that PR could be misdiagnosed as fibromyalgia, or that it could be overlooked in people with fibromyalgia, especially if it develops early. Because PR is most common after age 50, doctors may not even consider it in younger people. However, I recently had a 48-year-old reader contact me with her story:
"A couple of months before I started suffering of FMS, back in 1989, I had specific pain in my shoulders and lower back, with an extraordinary swelling of my shoulders and the base of my neck. Sometimes the swelling would take my whole arm including the top of my hand. Until last year I swore it was all part of FMS, despite reading many times that FMS does not produce swelling. Last year I found out the swelling comes from Polymyalgia Rheumatica." -Lucy
Lucy, thank you for your story and for showing us that PR isn't always related to age (and happy late birthday, too!)
Identifying Polymyalgia Rheumatica
The primary symptoms of PR include:
- Moderate to severe pain in the neck, shoulder and hips that's accompanied by inflammation
- Stiffness that's worse in the morning (as with fibromyalgia)
- Possible flu-like symptoms, including fever, weakness (sometimes reported in fibromyalgia; typical in chronic fatigue syndrome)
No single blood test can diagnose PR, but doctors look for an elevated sed rate, which shows whether you have inflammation. In people with fibromyalgia, the sed rate is typically normal (barring comorbid conditions that involve inflammation.)
A high sed rate is common to a lot of conditions, but taken along with symptoms and tests to rule out other conditions (such as rheumatoid arthritis), it can help a doctor diagnose PR.
Here's an article with lots of great information on PR, from About.com Arthritis Guides Carol & Richard Eustice:
The best news about PR is that it's easy to treat with steroids. The bad news, if you also have fibromyalgia, is that we don't tend to tolerate steroids well.
Do the symptoms of PR seem to fit you? Have you been tested for or diagnosed with it? Do you think your doctor may have overlooked it because of your age? Leave your comments below!
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