If you’re experiencing persistent pain, stiffness, or swelling, you might be wondering: Is it Polymyalgia Rheumatica (PMR) or Rheumatoid Arthritis (RA)? While both conditions cause inflammation and morning stiffness, they affect the body in different ways. Understanding these key differences can help you get the right diagnosis and treatment.
What Is Polymyalgia Rheumatica?
Polymyalgia Rheumatica (PMR) is an inflammatory disorder that primarily affects people over 50. It causes pain and stiffness in the shoulders, hips, and upper arms. Symptoms are usually worse in the morning and can make movement difficult. However, PMR does not typically cause joint swelling. Other symptoms may include:
- Fatigue
- Mild fevers
- Unintentional weight loss
What Is Rheumatoid Arthritis?
Rheumatoid Arthritis (RA) is an autoimmune disease in which the immune system mistakenly attacks the joints. This leads to swelling, pain, and long-term joint damage. RA can affect people of all ages but is most common in women between 30 and 60 years old. The main symptoms include:
- Swelling, tenderness, and warmth in the joints
- Pain primarily in the hands, wrists, and feet
- Potential joint deformity over time
Key Differences Between PMR and RA
One of the main differences between PMR and RA is the location of the pain. PMR mainly affects the muscles in the shoulders, hips, and upper arms, while RA targets the small joints of the hands, wrists, and feet.
Joint swelling is another distinguishing factor. RA causes swollen, tender joints, whereas PMR does not typically involve swelling. Morning stiffness is common in both conditions, but in PMR, it improves with movement, while in RA, it tends to persist throughout the day.
Blood tests can also help differentiate the two. Both conditions show elevated inflammation markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). However, RA often presents with specific antibodies like rheumatoid factor (RF) and anti-CCP, which are not found in PMR.
How Are PMR and RA Diagnosed?
Doctors diagnose PMR and RA using a combination of blood tests, imaging, and symptom analysis. Blood tests check for inflammation, while imaging tests like X-rays and ultrasounds can reveal joint damage, which is more common in RA.
If joint swelling and RA-specific antibodies are present, RA is more likely. If symptoms primarily involve muscle pain in the shoulders and hips without joint swelling, PMR becomes the more probable diagnosis.
Treatment Options for PMR and RA
Both conditions require treatment to reduce inflammation and improve mobility, but the approaches differ.
- PMR Treatment: Low-dose corticosteroids (e.g., prednisone) provide quick relief. Symptoms typically resolve within 3–6 months, with a gradual steroid taper to prevent side effects. In rare cases, methotrexate may be used for persistent inflammation.
- RA Treatment: Short-term steroids may help, but RA requires long-term disease-modifying treatments like methotrexate or biologics. Lifestyle changes, including an anti-inflammatory diet and regular exercise, also play a crucial role.
When to See a Rheumatologist
If you have persistent joint pain, swelling, or stiffness, it’s important to see a specialist. A rheumatologist can help determine whether you have PMR or RA and develop an effective treatment plan.
For expert care, visit Chicago Arthritis and Regenerative Medicine to schedule a consultation.
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