Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

What's The Best Way To Treat Polymyalgia Rheumatica?

Thursday, 15 July 2010 04:21 PM

Question: I was diagnosed with polymyalgia rheumatica in December of 2003. The pain was totally unbearable. I was on prednisone for one year, but it quit working. Being on five major pain killers for one year made me quit eating and I lost 50 pounds. In January of 2006, I went back on 10mg prednisone. The only other med I am on is Armour Thyroid 90 mg. Is this the best way to deal with this?

Dr. Hibberd's Answer:

Polymyalgia rheumatica (PMR) is an inflammatory condition of unknown cause associated with pain in the muscles of the neck, shoulders, and hips. As a victim of PMR, you are at increased risk of temporal arteritis (TA) with its potential for total blindness and stroke if left untreated.

15 percent of PMR patients have temporal arteritis. 50 percent of temporal arteritis patients have PMR.

Conventional treatment of these conditions in severe cases is with corticosteroid over two years. Pain that doesn’t respond to steroid treatment should be evaluated for co-existing and underlying medical conditions. Mild cases of PMR without TA are often treated conservatively with NSAID medications, with steroids reserved for persistent or worsening cases, or for the presence of TA.

PMR usually disappears within one to two years after treatment. Support groups are available. I usually recommend your care be supervised by a specialist called a rheumatologist in addition to your primary care physician

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