Polymyalgia Rheumatica & Fibromyalgia: 12 differences between two similar diseases

polymyalgia rheumatica

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Fibromyalgia and Polymyalgia Rheumatica (PR) are two conditions that can be confused as they have similar and sometimes overlapping symptoms.

PR is sometimes misdiagnosed as fibromyalgia, or is sometimes overlooked in people who have already been diagnosed with fibromyalgia, as it is so similar.

Fibromyalgia is a disorder that results in chronic pain, as well as fatigue, memory and sleep problems.  Symptoms include pain in the back of the head, at the shoulders, on the neck, upper hips, outer elbows, inner knees, and other areas.

Women are more likely to develop this condition than men. Other conditions that occur with fibromyalgia include chronic pain and tender points, as well as headaches, anxiety, depression, irritable bowel syndrome, and other health issues.

People with fibromyalgia often have trouble sleeping and experience anxiety, fatigue, depression, headaches and other similar issues.

Genetics may be responsible, as fibromyalgia tends to run in families. Infections or illnesses can trigger fibromyalgia or make it worse. Physical and emotional traumas can also trigger the condition.

There is no cure for fibromyalgia, and treatment includes medications to control symptoms, exercise and relaxation techniques, and other stress-reduction methods.

Polymyalgia Rheumatica

Polymyalgia Rheumatica is an inflammatory disease of the large arteries, and it generally develops in people who are older than 50 years.  PR is about twice as likely to occur in women as it is in men.

In this disease, the white blood cells of the body attach the joints.  Pain and stiffness are two of the common symptoms of this disease, and pain generally originates in the hip and shoulders.  Other symptoms include fatigue, weight loss, and fever.

12 Differences Between Fibromyalgia and Polymyalgia Rheumatica

The causes of fibromyalgia and polymyalgia rheumatica are unknown

Generally the first signs of PR include deep and aching pain the shoulders and in the pelvic area. Motion of joints from exercise can be aggravating to the shoulder and pelvic joints, and can cause increased pain in those areas.

This pain can prevent people with PR from sleeping well, and from completing other simple activities such as putting on a jacket or tying their shoes. Sometimes, patients have swelling in their knees, wrists, and other joints.

Synovitis is an inflamed joint condition caused by PR.  With synovitis, painful joint movement is usually an issue, and muscle pain and tenderness is also a problem.

PR is generally indicated by a blood test called Rapid Westergren ESR.  Sometimes, liver functioning tests will result in abnormal findings.

Treatment for PR includes therapy, which may last for months or years. On average, the duration of the illness is 2-4 years. The goal of treatment of PMR is to reduce pain and stiffness. Exercise is recommended for those who have energy, as exercise can increase joint functioning and can increase muscle strength.

Medications are administered to reduce pain and inflammation. The medication that is most often given to treat PMR are corticosteroids, while are similar to nonsteroidal anti-inflammatory drugs (NSAIDS) and cortisone similar drugs. Corticosteroids are very strong, and can help reduce inflammation. One of these is prednisone.

These may need to be taken briefly for months, or for longer years at a time.  NSAIDS are anti-inflammatory drugs and are less strong that corticosteroids. Aspirin and ibuprofen are both NSAIDS, as well as stronger medications.

If proven to work for a patient, NSAIDS are generally preferred as they have fewer side effects. Corticosteroids can lead to weight gain, cataracts, high blood pressure, glaucoma, and other negative side effects.

Medical marijuana is another promising avenue for the treatment of fibromyalgia. As its legal status is relaxed, even more research can be conducted into the effectiveness of marijuana, and both THC and CBD for pain relief, anti-inflammatory, and anti-anxiety uses.

 12 Facts about fibromyalgia and polymyalgia rheumatica

  1. PR sufferers specifically deal with pain in the neck, shoulders, and hips.
  2. PR sufferers have inflammation in the neck, shoulders, and hips.
  3. Both experience stiffness in the morning.
  4. PR has flu-like symptoms, including fever, weakness etc.
  5. Age of onset- PR generally appears only in people over the age of 50, while fibromyalgia can come much earlier.
  6. PR symptoms come on suddenly.
  7. Fibromyalgia symptoms are generally present for longer periods of time.
  8. PR usually goes away within 1 to 4 years of the first bout of symptoms.
  9. PR is treated with corticosteroids.
  10. Fibromyalgia is treated with stress management and lifestyle modifications, as well as medication.
  11. PR is managed by corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDS).
  12. PR can be diagnosed with the help of the blood test Rapid Westergren ESR (Erythrocyte (red blood cell) Sedimentation Rate).

It is important to distinguish between fibromyalgia and Polymyalgia Rheumatica in order to best treat the condition and reduce pain and discomfort as best as possible.  This can lead to a fulfilling life for those who suffer from chronic pain.



  • http://www.drstephenrodrigues.com Stephen S. Rodrigues, MD

    This is vital;
    The most important treatment in FM is exercise and Myofascial Release Therapy with hands on manipulation and with needles like Acupuncture and trigger point injections (no steroid injections)

    PMR can be gradual but the age is an important point. PMR has more weakness, loss of power and stamina. PMR patient will tend to have weight loss too. The blood test for PMR maybe normal, so called inflammatory marker negative PMR.

    PMR is more or less completely treated with oral or injectable steroids, so all of the weakness, aches and loss of power will disappear.

    Both can be a side effect of medications too, the only treatment for medication induced “FM or PMR” is to discontinue the medication. Statins and Quinolones are the main culprits.

    • Johanne

      “The most important treatment in FM is exercise. .” Have you lost your mind? You can’t even begin to exercise until the most difficult symptoms are addressed first. Sometimes I could barely leave my bed and make it to the bathroom! Exercise.. most important? What’s wrong with you? Sometimes I wear sunglasses in the house because of the acute sensitivity to light. When FM is concentrated in my feet I hobble. And until I was prescribed hydromorph, the unyielding body aches and the acute , sharp, stabbing pain left me bedridden. It took what felt like endless over-the-counter pain medications and nausea drugs to combat the pain medications. Exercise. Yours is a sad example of someone entirely disinterested and uninformed about Fibromyalgia. Sadly, you will have caused a great deal of additional pain for many naive, FM patients since you wrote your comments. Exercise. Pain. Addressing the pain is the most important treatment. Get that right and your patients will gladly exercise.

      • Linda Reynolds

        Agreed I’m in agony just walking to the bathroom

      • Cherylnne Catri Kirby

        I have had FM since the 80’s diagnosed in 1990. Been through every therapy, drug protocols, alternative medicine, you name it I’ve tried it. I felt just as you do that with the level of pain I could not have a life. I stayed on that path until about 2 years ago. Now I practice meditation daily, relaxation exercises, yoga trapeze work out daily and grounding in nature daily. I am still in pain most of the time but it is as managed better than ever now. I agree that movement is key. If all you can manage is a trip to the bathroom, try moving while in bed. Feet circles, arm raises, stretching gently and visiulation therapy, biofeedback all can be done gently and in small steps. Please don’t give up. I was wheelchair bound for five years. https://uploads.disquscdn.com/images/e4b41eebb1e9d44fe824db684dc1c80c0e9fc02f75c47cc08ebdddd16fea49db.jpg https://uploads.disquscdn.com/images/0f72fb411d6bfbc19fda50e02ca0ff22682ca46cc93df69034377f53b31506b9.jpg

  • Jan

    Iv was told I have pr, but I’m confused as I thought it would go away,,as I’ve had it 4years, but my hands , legs, feet and hips hurt so.much the hands are numb,with pins needles, I’ve such headaches can’t sleep ,,moody cos I hurt so much,so not long been.off steroids even though they didn’t help much this time round,I’m on anti inflammatory pills and a lot of painkillers, so why do I hurt so much,,

    • Jenna J. Duffell

      Try Tumeric 500 mg & Magnesium for headaches, that’s what my doc has me on, but I have miagraines so I take Topamax 100 mg 2x day as well. I will tell u the OTC regimen has really made a big difference, enough for me to go down on prescription med. It does take week or so to get into ur system. I’m not a medical professional, so talk to ur physician don’t just take what works for me. I do understand though, & hope u get
      some relief & good advice frm ur Doc. Take Care!!

  • http://www.sundancecosmetics.com SundanceCarmen

    https://www.sundancecosmetics.com/products/hemp-extract-drops?utm_campaign=facebook-5060978144569&utm_medium=shopkey&utm_source=facebook this is what I take for autoimmune issues. No side affects and it relieves pain and inflammation.

  • disqus_bB3lY2fpGl

    So after more reading from other sites as well, I’m still confused about what I actually have. I have the shoulder/neck / Hip pain etc, but cannot say I get that many headaches (those I get usually are secondary to neck stiffness…..& that can also be due to Osteo-arthrites?) The main symptom that I have that really annoys me is the “burning sensation ” that I get under the skin. this symptoms is much worse in the Summer Heat here in QLD Australia. I do have the Lethargy, Weakness and Muscle / Joint Pains too at times. When I read re the Ibobrufen assisting PMR This has me thinking, as I feel the 4 medications that help me the most are Endep, Gabapentin, Brufen and Valium. I know I am not depressed, but do get agitated with the Increase in pain. Does anyone have an answer to this one (I do take magnesium supplements too, which helps the Restless legs etc)