Polymyalgia rheumatica: Diagnosing the condition

Written in association with: Dr Taher Mahmud
Published: | Updated: 16/01/2024
Edited by: Cal Murphy

A patient with undiagnosed polymyalgia rheumatica (PMR) presents with a sudden onset of stiffness and muscle aches, particularly around the hips and shoulders. These symptoms are so severe that they change her day-to-day life - she can’t dress herself, do exercise, or go to the shops. She feels old; much older than she should. Enter leading London rheumatologist Dr Taher Mahmud

Woman with polymyalgia rheumatica sat on a bench

What's a typical case of polymyalgia rheumatica?

Dr Mahmud took the case of a female patient over the age of 50 suffering from pain and stiffness around the two 'girdles' (groups of bones that form a ring to anchor the limbs to the body) – the pelvic girdle and the shoulder girdle. She presented with the following symptoms:

  • Aching around the shoulders, hip girdle and neck
  • Stiffness, particularly in the mornings

 

Her quality of life was being hampered by these symptoms. She struggled to dress herself, needing to swing her trousers to hook them over her foot in order to get them on. She was unable to go to the shops and back, let alone the gym to do some exercise, and generally felt incapacitated.

 

 

How was PMR diagnosed?

The patient was diagnosed with PMR - an inflammatory rheumatic condition. Classic symptoms include:

  • aching and stiffness in the mornings around the shoulders, neck and hips, as seen in our patient.

PMR may also cause:

  • tiredness; 
  • loss of appetite; 
  • weight loss, and; 
  • depression.

Polymyalgia rheumatica rarely occurs in patients under 50 years of age, and its prevalence increases with age, with the majority of cases being diagnosed in patients between 70 and 80.

 

PMR is more common in women than in men, and occurs more often in Caucasians than other races; however the lifetime risk is relatively high across the board, and as far as systemic rheumatic diseases go, it is second common only to rheumatoid arthritis. In fact, sometimes PMR can be a feature of rheumatoid arthritis and other inflammatory conditions.

 

PMR is often associated with temporal arteritis, a.k.a. giant cell arteritis (GCA) – an inflammatory disease involving the narrowing or even blockage of blood vessels in the neck, arms, and scalp. Temporal arteritis can prove very serious, potentially leading to blindness.

 

 

How is polymyalgia rheumatica treated?

PMR treatment usually consists of steroid medication to manage the symptoms. The corticosteroid prednisolone is commonly prescribed, due to its ability to block the effects of chemicals in the body that cause inflammation.

 

However, steroids such as these don't cure the condition; rather they work to improve quality of life. Steroids, like many medications, can potentially cause side effects, and you should always consult your doctor or a specialist before taking anything, as they will be able to recommend the best course of action for you.

 

In the case of our patient, Dr Mahmud was able to successfully diagnose polymyalgia rheumatica, and treat the condition accordingly. The patient responded rapidly to the treatment. Her symptoms cleared up, and she was once again able to dress herself, go to the gym, play with her grandchildren, and live her life to the fullest. In her words, she had her life back.

 

 

 

If you would like to arrange an appointment with Dr Mahmud, you can do so via his Top Doctors profile

Dr Taher Mahmud

By Dr Taher Mahmud
Rheumatology

Dr Taher Mahmud is a distinguished consultant rheumatologist based in central London and Tunbridge Wells. He is renowned for his expertise in osteoporosis, osteopenia, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and inflammatory arthritis.

Dr Mahmud qualified in medicine from King's College London before undertaking training at various esteemed institutions including St Thomas', and Pembury Hospitals. He also completed an esteemed research fellowship at King’s College Hospital, also gaining an MD and a Master’s in biochemistry. He further honed his skills in rheumatology through specialist training at King's College, the Lupus Unit at St Thomas', and Guy's Hospital Rheumatology Units. Dr Mahmud has served as a consultant rheumatologist since 2000, and was awarded fellowship of the Royal College of Physicians in 2014. Boasting more than 30 years of experience, Dr Mahmud has held various prominent roles throughout his career, including as cofounder and clinical lead for osteoporosis at the London Osteoporosis Clinic, and has also received a Clinical Excellence Award in recognition of his excellence and dedication to his practice. He currently sees private patients at HCA UK, The Shard and 25 Harley Street.

Additional to his clinical practice, Dr Mahmud has held a number of esteemed positions in public associations throughout his career, with a particular focus on improving patient experience and outcomes, including as a member of the MTW Patient Experience Committee and as an organiser and chair of conferences on patient experience at the Royal Society of Medicine. In recognition of his commitment to drive improvement in this area, he was awarded an NHS Innovations award for patient feedback. He has also been actively involved in medical education throughout his career, having lectured and trained a wide range of medical students and fellow practitioners.

With a wealth of expertise and experience, Dr Mahmud continues to make significant contributions to the field of rheumatology. He has appeared in numerous peer-reviewed publications and has authored his own book on the subject of patient care and feedback. Dr Mahmud is passionate about raising awareness of the prevention of osteoporosis fractures and maintaining healthy bones. He has appeared on several podcasts as an expert speaker on bone health and osteoporosis and the menopause. Dr Mahmud is also a member of various professional organisations, including the American College of Rheumatology, British Medical Association, British Society of Rheumatology, General Medical Council and the Royal Society of Medicine.


  • Related procedures
  • Platelet-rich plasma
    Ozone therapy
    Neuropathic pain
    Vasculitis
    Elbow Pain
    Bursitis
    Knee osteoarthritis
    Growth factors
    Trapped nerve
    Spinal osteoarthritis
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.