Polymyalgia differs from fibromyalgia

Peter H. Gott, M.D.

DEAR DR. GOTT: Please give me some insight on polymyalgia. Within one year, I’ve had three friends diagnosed with it. What causes it? Is it curable? Is it related to fibromyalgia?

DEAR READER: Polymyalgia rheumatica is a disorder that causes stiffness and muscle aches, primarily of the neck, shoulders, upper arms, thighs and hips. While the condition can develop gradually, it can also appear almost overnight.

Because its symptoms are so similar to other conditions (rheumatoid arthritis, polymyositis, etc.), testing needs to be performed by a physician. This primarily consists of a physical examination, patient history (such as when symptoms started) and blood work.

PMR and fibromyalgia often cause similar symptoms but differ in several important ways. The first is that PMR is caused by inflammation; the cause of FM is unknown. Next, FM is usually chronic, meaning it lasts for many years or a lifetime; PMR ordinarily resolves within two years. And, finally, PMR is thought to be caused by an abnormal immune response, while fibromyalgia is believed to be caused by abnormal brain chemicals and signals.

Treatment consists primarily of nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, which can be effective in treating minor pain and stiffness. Beyond that, corticosteroids prescribed by a primary-care physician or rheumatologist should provide relief.

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