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!
Learn more or join the conversation!
NEWSLETTER | FORUM | BIO | TWITTER | FACEBOOK
Photo © Bruce Laurance/Getty Images
Oh, my. I developed PR about 3 1/2 years ago on top of a ten year case of fibromyalgia. I thought my fibromyalgia had just worsened. My doctor took lots of blood tests to find out what was wrong, and diagnosed me with PM. If you read about PM on the Mayo clinic site, three different viruses can trigger PM which is an auto immune condition. I had the childhood virus. PM is commonly treated with prednisone, but while it initialy seems like a miracle cure, if you have fibromyalgia, DONT TAKE IT. Dr. Teitalbaum says that immune systems are already compromised with fibromyalgia. On prednosone, my immune system completely colapsed. I will write more, but am sending this now.
I have had FM for years as well as AS and other painful back conditions but after reading this posting and Dr. Teitalbaum’s book, I am concerned. I have been on prednisone and have been weaning myself off of it now only taking 2.5 mg daily for pain from inflammation. I notice a marked increase in severe pain but will continue to wean off of the prednisone. Thank you for the article.
Hi
I was told this year that i have got polymyalgia rheumatica
and fibromyalgia
i have had this condition for 3 years and the pain is so bad that you dont want to move but you have to carry on moveing about or it will be worst
it just started with a very bad cold, tryed lots of diffirant tablets but nothing seams to make the pain go away for long i have good days and bad days when i just do not want to do anything at all,
It wouldn’t surprise me one bit if I also have this in conjunction with fibromyalgia…I always have swelling in the oddest places that just don’t “fit the fibro profile” including and not limiting my ankles, around the foot itself and then some. It figures there wouldn’t be a reliable test for this either such as with fibromyalgia..we can send a man to the moon but we can’t yet diagnose alot of these conditions? What is wrong with this picture I ask???????
Thanks! I had a great time celebrating with my family at a restaurant.
And about Lucie’s comment, my ankles also swell, but not as bad as my shoulders, upper arms and base of the neck. And if I peal more than a couple of potatoes, for example, my fingers, top of my hands and top of my wrists swell immediately, besides the pain. I can’t wear most of bracelets or rings or necklaces. I have to weigh them first (in my hand) to make sure they won’t increase the pain and produce additional swelling.
I chose not to use steroids or any other medication as a steady treatment. PMR has no cure. When the pain is too much I take a very hot shower, take some ibuprofen, get my favorite ice cream and listen to my favorite music. Sooner or later the pain will decrease, and then I keep moving on.
I was 48 when I first started having problems. I hurt all over, was tired all of the time, had pain in my back along my shoulders. I also had had shingles a couple years before that had started on my right shoulder blade. But my main symptom was my hands and wrists were swelled most of the time, especially in the morning. I went to the Dr. thinking that I might have rheumatoid arthitis. He did a lot of tests and came up with a diagonsis of polymalgia based on my sed rate which was sky high. I was given predisone which seemed to help at first, but I got to the point that I could not tolerate it. I also felt like I had the stomach flu most of the time. I ended up going to see a rheumatoligist who then decided that I had fibro based on my tender points. He also was not a nice person. He put down my complaints of pain, told me that all I needed was to think positive and to try harder. Needless to say, I was really a mess by then. I had got to the point that I was having a hard time making it to work when it was all I could do just getting out of bed in the morning. I had a job where calling in sick was not on option unless you were contagious. I ended up with a Dr. who believes what I say and treats me like a human being. We worked together and I can at least function on most days. I also ended up quitting my job and am on disability now. To make a long story short, I wonder if I have both fibro and poly. My sed rate still runs high and if I do much with my hands they will swell and hurt. My feet are the same way. I know what I will ask my Dr. on my next visit. I didn’t realize that you could have both. P.S. Thanks for listening to me.
I have had FMS for many many years – most of them without knowing but definitely suspecting. for the last two years I have had swelling in my left leg and specifically in my ankle – which I have broken 3 times (due to my lack of balance and vertigo). the doctors say that I should expect my ankle to be swollen (and my leg?) because of all the trauma. i have to take anti inflamation medication twice a day with meals just to get through the day. who knows what I have?? the doctors certainly do not know!!
I have an aunt and an uncle (brother and sister of my father) who both have poly and I have had fibro and cfs for 17 and 3 years respectively. Is is then likely I’ll go on to develop poly like my aunt and uncle? Im 45 now but my aunt and uncle are in their 70’s. My daughter is 24 now and we think she has had fibro for the past 18 months but they wont refer her to a consultant for diagnosis, although are giving her low dose amatryptaline. Id say we have a family “history” if not hereditary wouldnt you?
you it really hurts to be in pain and no one believe you. i cannot even visit my other family cause i know i don’t have balance so i prefer to be near the one’s who know me. i have all the above syptoms and i was told 8yrs back that i have FMS but suffered for the past 18yrs with out a clue. i really thank you guys for sharing your stories.
my present problem is ankles which are very painfull and become swollen. i have some lumps on my legs which leave a spot as if i burn myself. this lumps start as if something bite me, the happen inside my skin and after some days i see a dead skin coming up. i cannot wear a short now it looks as if i have burned patches. the spots are not painfull but they are become red when it is hot. i notice them last winter and they stop but again this winter they back.
i am a black south african women. this does not stress me because i’ve read about my condition. sory i also have psoriasis and psoriathic arthritis. when i was young i had juvenile polyarthritis. i think this i all conected to (autoimmune system). the only thing that keeps me going is that i still wake up and go to work. i don’t get tired all the time some days because i supplement, i also sleep well. the onlt serious problem is the 24/7 pain in all of my joints especially ankles,shoulders,fingers and spine.
I PRAY FOR ALL OF US TO BE HEALED, IN THE NAME OF JESUS CHRIST. HE SAID HE WILL NEVER LEAVE OR FORSAKE US JUST PUT YOUR TRUST IN HIM HE WILL DO THE REST.
Diagnosed w/PMR about 6 wks. ago. Taking prednisone; hate this drug! Hope to have dosage decreased shortly. Side effects terrible.
Pain/problems with shoulder, arm, neck muscles actually began 2 to 3 years ago after a very stressful period in my life: shingles attack end of Dec. 2007; shortly husband diagnosed w/cancer & passed away within a month. Family history of auto-immune disease (sister who passed away). Can stress play a big part in this PMR?
I need your help rather than leaving a comment.I can’t get a Doctor to give me any medication that really helps my Fibro pain.I had a spinal fusion done in February and the Doctor gave me Percosett.It helps my Fibro pain and back pain greatly but now my back Doctor said I have to go to pain management.I know Doctors don’t like to prescribe Opiates for Fibro but it’s the only drug I have taken that really helps my pain.Can you give me any advice as to what I should say or not say to the Doctor? I really find that an Opiate helps me so much.I am able to work more when I take it.Your advice would be greatly appreciated.
Lynette,
It’s true that many doctors don’t like to prescribe narcotics for fibromyalgia. Since they help with your back pain, try to keep that the focus. A pain-management specialist should (I hope!) understand that any pain will basically aggravate fibromyalgia, so when your back is worse your fibro will be worse. Hopefully, the specialist will look at you as a spinal fusion patient who also has fibro and will treat your back pain appropriately.
Best of luck to you!
~Adrienne
dollar,
I have Fibro and have recently been diagnosed by my dermatologist with Erythema Nodosum, as I have tender, slightly red lumps under the skin on my lower right leg. I’ve been doing much reading on them and noticed they are slightly warm to the touch as well, and look a bit like burns, as the lumps are not visible, they are found when you tough them lightly. Could this be what you’ve got?
They are associated with infections – anything from strep to tuberculosis – as well as other conditions like IBD and Lupus.
Look up EN and make sure you get checked for anything else associated with this, if you suspect you might have it. Best of luck to you.
Benia
I wanted to follow up with you regarding my last comments on trying to get a Doctor to give me Percosette which contolls my back and Fibro pain wonderfully.Well,The Pain Management Doctor did exactly what I thought he would do.He told me he would not prescribe it.He tried to get me to use Steroids,which make me sick.So that was a waste of $40.00.So I went to see my Primary care Doctor and I basically did a “Presentation” for her.I took my information which was all from your newsletter, and highlighted it with yellow marker and presented my empty bottle of Percosette and my bottle of Ultram and told her that this combination of medications almost lets me feel like a normal person when taken together.Unbelievably she made me sign a MEDICAL CONTRACT and prescribed me one pill a day.This contract requires that I must see her every 3 months and if she requests it, that I can be drug tested to see if I am abusing it.Because of the drug problem in this country those of us who really need medication have to suffer with pain and be denied what will help us.I have suffered for 5 years now.It is rediculous what I have had to go thru to get pain relief!
I was just recently diagnosed with PMR. Iam 57 yrs old & a practicing Nichiren Buddhist. I saw two rheumatologist & the 1st one said I would need a low dosage steroid. The second said I would need a sleep study. Since I have CHF, obesity, & diabetes I opted for the sleep study. Now I’m on a Bipap machine for mild sleep apnea. It was suggested that I try a molecularly distilled fish oil supplement since I’m already on an aspirin regimen & more aspirin could affect my hearing & further aggravate my stomach issues. I take Coreg, Victoza, Lasix, Klor-Con M20, Florastor, Vitamin D 2000 units a day, Atacand, & Simvastatin along with aspirin @ 325mg. I don’t want to ever be on steroids again. I was prescribed 80mgs for two weeks then taken off cold turkey for a biopsy. The withdrawl & elevated blood glucose was horrible! What can I do? Since 4am today, I’ve been in severe hip pain, moderate neck & shoulder pain & the stiffness in my whole body makes it extremely difficult to walk or rise from sitting. I can’t sleep well for more than 2/3 hrs. Even after a LP to see if I had vasculitis the doctors don’t know what’s causing my extremely high sedamentation rate since the test was negative. What should I do? I know that my chanting Nam Myiho Renge Kyo will lead to a final & victorious solution, but Buddhism is faith & REASON so I must take action too. I need the wisdom of a compassionate & knowledgable physician. Thank you.
Doris,
The problem with your hip could be due to the simvastatin. I was just taken off this awful med after only 2 months. I was forced to use a cane, since my hip muscles would no longer support me…there are several interenet sites documenting the muscular side effects of simvastatin. I hope you find some relief.
I’m 48 and I haven’t been diagnosed with PMR officialy, my doctor told me theres no way i have it because i’m not 50. Are you kidding me i left his office so angry because my symptoms fit to a tee. I took to rounds of prednisone the pain went away within hours, by the end of the prescription I couldn’t wait for it to be gone. It’s been three months since the pain started I now keep ibuprofen in my system 24/7 and also take tremodol when the pain gets too much. I need alot of sleep now really can’t get enough. Although i wish no one suffered like me it’s nice to hear from others with the same issues. TRY TO KEEP YOUR HEAD UP IT CAN’T LAST FOREVER!!!!!
Doris Bryant
Both the sed rate and reactive c protein (RCP) are really high in PMR. To obtain an accurate result of you RCP you need to have an Ultrasensitive RCP test, not the normal test. I’ve had my sed rate over 45 since I’m 27 years old (now 48) and my RCP right now is in 6.3, more than twice the highest acceptable level. Both issues together is PMR for sure.
I chose not to take steroids. For me it’s hot showers and 1000 mg ibuprofen when the pain is way too much. I use it for a few days and as soon as the pain is bearable, I quit taking ibuprofen. But your condition is far more complicated than mine, so you must be extremely careful to mix further meds.
hi i don’t know where to began. I’ve suffered with muscle pains as for back as i can remember. when my mother took me to the doctor she was told because i do sports. now that i am 40 it is even worst. been to hospitals many time was even asked did i have a mental record. denied pain meds before. finally a sweet young lady was on duty one morning i thought it was going to be the same as all the others times, began to tell me stuff that i had been trying to tell for years. as she began to speak i began to cry finally someone who don’t think i’m crazy. all i can do now is thank GOD. i don’t know what the problem is yet but this dr appt i will keep. on the 27th the tests will begin
I have just been dx with pmr. My mother also has it. I have had fms for 20 years. I am 58. I just thought my fms was getting worse. I have difficulty sleeping, can’t seem to “shut my brain off” at night to fall asleep. Does anyone else have this symptom? I also take Lexapro. I was started on a tapering dose of prednisone, starting with 20mg. I must say, in two days, I am felling better than I have in years. It’s been so long, I don’t remember what living with pain felt like. I wish there was more awareness for people that suffer from chronic pain. I am a nurse and some doctors that I work with, still don’t believe in fms. My sed rate has been elevated for years. My hsCRP started creeping up about 5 years ago.
I have pmr and was recently diagnosed with osteo arthrithis.
I cannot stand, sit, or walk without pain. I am on steroids, cymbalta and celebrex. So far I have very little improvement.