Polymyalgia Rheumatica vs Rheumatoid Arthritis
Polymyalgia rheumatica (PMR) is an inflammatory condition that commonly affects people over age 50. It is treated with low doses of prednisone and typically improves with time and treatment. Some people who are diagnosed with PMR can eventually be diagnosed with rheumatoid arthritis (RA), which is an autoimmune disease. This is not because PMR causes RA, but because PMR is misdiagnosed due to its resemblance to RA. So, when it comes to polymyalgia rheumatica vs rheumatoid arthritis, it is good to know the similarities and differences. Let’s take a look.
What Is Polymyalgia Rheumatica?
According the Vasculitis Foundation, PMR affects 59 out of every 100,000 people over age 50 per year, most of which are Caucasian women. It is the most common inflammatory condition affecting elderly people with its average age onset around 70.
PMR causes muscle pain and stiffness, especially in the shoulders. Polymyalgia rheumatica symptoms usually begin quickly and are worse in the morning.
In addition to muscle pain and stiffness in the shoulders, PMR may cause pain in the neck, upper arms, buttocks, hips and thighs. Some of these areas may also be affected by stiffness and limited range of motion.
Other symptoms a person with PMR may experience are:
- Mild fever.
- Fatigue.
- Loss of appetite and unintentional weight loss.
- Depression.
You should see a doctor if you have aches, pain and stiffness that is new, disrupting or limiting your ability to do routine activities, such as showering and getting dressed.
What Causes PMR?
An exact cause of PMR is unknown but there are risk factors researchers believe are related to the condition. These include:
- Genetics. Having certain genes and gene variations may increase a person’s risk for developing PMR.
- Infection. Viruses may play a role in the development of PMR, but researchers have yet to point to a specific virus that may cause PMR.
Polymyalgia Rheumatica Treatment
PMR is treated with low to moderate doses of the corticosteroid drug, prednisone. The disease is limited in the harm it causes and lasts from one to five years. It can be cured with treatment.
What Is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system mistakenly starts attacking the joints. This process creates inflammation in the synovium (tissue lining the joints) and causes swelling and pain in and around the joints.
According to the Arthritis Foundation, 1.5 million people in the U.S. have RA and the majority are women; women are three times more likely to develop the condition.
RA commonly affects the hands, feet, wrists, elbows, knees and ankles, but it can affect any joint. RA can also affect organs, including the skin, lungs and heart. Because it is a systemic disease, it can affect the entire body.
Joint Damage and RA
Unchecked inflammation eventually damages cartilage (the elastic tissues covering the ends of the bones in a joint). Over time, cartilage loss and joint spacing makes joints unstable, loose and painful and can eventually lead to loss of mobility.
Irreversible joint damage may occur. Irreversible joint damage can also occur in the very early stages of RA, which is why doctors recommend an early diagnosis and aggressive treatment to control the disease’s progression.
What Causes RA?
Much like PMR, a specific cause for RA is unknown. No one knows for sure how the immune system overacts, but there has been evidence suggesting that genetics, hormones and environmental factors are involved.
What Are the Treatment Options for RA?
Treatment for RA involves aggressive methods to stop inflammation in an effort to put the disease in remission. Treatments are used to try to relieve symptoms, prevent damage to joints and organs, improve physical function and prevent disease complications. As said before, joint damage can occur and inflammation to the organs and other body systems can happen as well.
Corticosteroids, including prednisone, for treating RA are reserved for periods of flare-ups, when the disease is more active. These medications are effective because they are quick acting towards inflammation, but because of the serious side effects, they are only used short-term and in low doses.
Polymyalgia Rheumatica vs Rheumatoid Arthritis: What’s the Connection?
PMR is known for causing acute musculoskeletal inflammation in the elderly, whereas RA causes joint pain that can affect anyone of any age, but is often diagnosed in middle age.
While both conditions cause pain and stiffness, PMR mostly affects the shoulders. RA is known for affecting joints throughout the body, although it seems to wreak the most havoc to the smaller joints of the hands and feet.
About 30% of people with PMR develop symptoms similar to those that are commonly seen in people with RA. This may include joint swelling and pain and degenerative changes (normal body wear and tear) in their joints.
In people who have mild joint inflammation with RA, a PMR misdiagnosis may occur. In fact, up to 20% of people who are diagnosed with PMR are eventually diagnosed with RA.
Proper nutrition, activity, rest and medicinal treatment are important for the management of both PMR and RA. When symptoms are managed, a person can typically return to daily activity and enjoy a quality life.
The Bottom Line
Polymyalgia rheumatica vs rheumatoid arthritis are two very different conditions. While they have many differences, one of the most significant is that PMR, with proper treatment, will eventually go away. This is not the case for people with RA, who will live with the disease for the reminder of their lives.
If you have been diagnosed with PMR and are still having symptoms despite treatment, ask your doctor about further testing to determine the cause of your symptoms. A referral to a rheumatologist may be needed.