What are PMR and GCA? Simple explanations of the ... - PMRGCAuk

PMRGCAuk

13,606 members24,778 posts

What are PMR and GCA? Simple explanations of the basics for family and friends

PMRpro profile image
PMRproAmbassador

I am a member of another forum where we had an easy to find section with this sort of information. Some one asked for a non-academic explanation of PMR the other day so I have taken the one from there to repeat here.

The basics of PMR:

Polymyalgia rheumatica is disorder that affects large muscle groups in the body with episodes of pain and stiffness. Polymyalgia rheumatica is generally a disorder of older adults over the age of 50 and affects twice as many women as men. In general, the older a person is, the higher the risk of developing the condition.

The cause of polymyalgia rheumatica is not known, but it may be due to an abnormal response of the immune system. In an autoimmune disorder, the body's immune system mistakes healthy tissues as foreign and potentially dangerous invaders into the body and attacks them. This results in inflammation and may lead to the painful symptoms of polymyalgia rheumatica.

The symptoms of polymyalgia rheumatica usually appear suddenly and are moderate to severe. The hallmark symptoms are pain and stiffness on the neck, hips, and shoulders. About 15 percent of people with polymyalgia rheumatica develop a potentially serious complication called temporal arteritis, which includes additional symptoms. For more details on symptoms, refer to symptoms of polymyalgia rheumatica.

Making a diagnosis of polymyalgia rheumatica begins with taking a thorough medical history, including symptoms, and completing a physical examination. There is no precise test to diagnose polymyalgia rheumatica. Medical tests generally include a variety of blood tests that are nonspecific, but their results may increase the suspicion of a diagnosis of polymyalgia rheumatica. These tests include a complete blood count (CBC), which can reveal anemia, one of the symptoms of polymyalgia rheumatic. They also include an erythrocyte sedimentation rate (ESR), which can reveal an inflammatory process occurring in the body.

Tests are also done to rule out other conditions with similar symptoms, such as rheumatoid arthritis.

It is possible that a diagnosis of polymyalgia rheumatica can be missed or delayed because the disease may appear similar to other conditions or diseases, such as aging, influenza, and fibromyalgia. For more information on misdiagnosis, refer to misdiagnosis of polymyalgia rheumatica.

Polymyalgia rheumatica usually disappears on its own without treatment. However this can take several years. In the meantime treatment can be very effective in relieving symptoms and helping people to live normal, active lives. Treatment varies depending on the severity of symptoms, the presence of complications, a person's age and medical history, and other factors. Treatment can include a combination of medication, regular exercise, and eating a healthy diet.

I will also add the GCA Basics article here:

Also known as temporal arteritis or cranial arteritis, giant cell arteritis is the most common form of vasculitis that occurs in adults. Almost all patients who develop giant cell arteritis are over the age of 50. Temporal arteritis commonly causes headaches, joint pain, facial pain, fever, and difficulties with vision, and sometimes permanent visual loss in one or both eyes. Because the disease is relatively uncommon and because the disease can cause so many different symptoms, the diagnosis of temporal arteritis can be difficult to make. With appropriate therapy, temporal arteritis is an eminently treatable, controllable, and often curable disease. The disease is called temporal arteritis because the temporal arteries, which course along the sides of the head just in front of the ears (to the temples) often become inflamed. The term giant cell arteritis is often used because when one looks at biopsies of inflamed temporal arteries under a microscope, one often sees large or giant cells.

Who gets Giant Cell Arteritis?

Temporal arteritis is a disease of older people. The average age at onset is 72, and almost all people with the disease are over the age of 50. Women are afflicted with the disease 2 to 3 times more commonly than men. The disease can occur in every racial group but is most common in people of Scandinavian descent.

Classic Symptoms of Giant Cell Arteritis

The most common symptoms of temporal arteritis are headache, pain in the shoulders and hips (called polymyalgia rheumatica), pain in the jaw after chewing (called jaw claudication), fever, and blurred vision. Other symptoms can include tenderness of scalp (it hurts to comb the hair), cough, throat pain, tongue pain, weight loss, depression, stroke, or pain in the arms during exercise. Some patients have many of these symptoms; others have only a few. Blindness the most feared complication can develop if the disease is not treated in a timely fashion.

What Causes Giant Cell Arteritis?

We do not know. We do know that aging has something to do with the disease. And we know that the body's immune system attacks and inflames the arteries. But we do not know why the immune system attack occurs when and where it does.

19 Replies

Thank you PMRpro; this is very useful. I will keep it to inform my friends (and dare I say it, our local doctors. And even the rheumatologist......)

I well remember that explanation many moons ago and searched my computer when I read that post. I gave up after a couple of hours.

On 12th May 2010 at 9.45am sitting outside in a wheelchair, I met someone with PMR, knowledge and a good memory. Stay well and safe xxxx

PMRpro profile image
PMRproAmbassador in reply to jinasc

Doing my best!

Thank you for posting this!

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Just a comment on common Classic Symptoms of GCA above - if you have cranial GCA (Temporal Arteritis) only and not PMR, you usually have issues with shoulders only not hips, and can very often be diagnosed initially with a frozen shoulder.

Thank you for posting this. I always find it difficult explaining PMR to family and friends.

Thanks for these excellent explanations, really useful for puzzled friends.

Very useful! Thanks for this. Only thing I would add, CRP is not mentioned and in my case my ESR was classed as within the normal range in the 20s but my CRP at 27 clinched the diagnosis. Both have been in low single figures since taking pred.

PMRpro profile image
PMRproAmbassador in reply to Rache

Your family and friends aren't interested in the blood tests - unless they are like me ...

Thank you so much.

Very good post and interesting to learn how closely PMR and GCA can be the same symptoms. I've suffered from headaches for years and years, then came the neck and shoulder pain...all put down to the ageing process, but could have been PMR lurking back then. The symptoms I experienced with GCA were: Jaw claudication, tender head (not temples) and headache. I think it was nipped in the bud, but very aware it could return whilst reducing. Good article that I've now printed off to keep.

Thank you very much for this excellent explanation - very helpful.

Interestingly, it was only this morning that I was toying with the idea of a Frequently Asked Questions sheet for PMR from a non specialist viewpoint.

'

It seems to me, after six years on this Forum ( not that long by some people's experience) that so many questions cover similar topics.

If something like this could be kept short, simple and easy to read, might it help, or would it be, quite simply, not practicable bearing in mind the scope of PMR ?

Paddy

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to Charlie1boy

It has been much discussed - and again recently...but it does mean that a lot needs to go on in the background before it can be achieved. @PMRpro has made a start by trawling through her records...

hence this post!

Yes, I do understand that. What started me off was the number of times posts ask what to do when a flare comes along. I guess it's not that simple at the end of the day, and not really helped my NICE guidelines for PMR treatment.

Exeter not quite good enough yesterday, but what a game!!

Paddy

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to Charlie1boy

Good game, wrong outcome, but never mind...have to go for Premiership now!

PMRpro profile image
PMRproAmbassador in reply to Charlie1boy

Such a thing exists on another forum, the first PMRGCAuk charity forum as it happens, started after some ladies met on the patient.info forum. The format there allowed it to be done very easily but the format here is fairly useless for doing that sort of thing and we have tried to work out a way of doing it for a long time. I will be able to access these from my own profile here as well as however we manage to sort it out - I thought I might just as well post them in the meantime so you will see a lot of activity in the near future.

The repeated questions are because people simply don't read all the posts. I know it isn't easy now - but this week there were two identical posts on one day!!

Charlie1boy profile image
Charlie1boy in reply to PMRpro

Yes, I can quite understand that about people just not reading posts. I'd find that really frustrating.Cheers

Paddy

Hh

Hi I thought your explanation to GCE and Pmr was great easy to understand, Iwas first diagnosed with GCA.and started on a high dose of prednisalone, much later had a biopsy but had symptoms of GCA Ihave PMR and have had to to put my meds up to 15% with my Rheumatologist help,I'm feeling better but it takes a awhile to come right, I was in quite a dark place afew weeks ago but I don't feel so alone now your help and jokes are a great tonic,THANK YOU SOMUCH.

You may also like...