How should polymyalgia rheumatica be managed?

Polymyalgia rheumatica (PMR) is an inflammatory condition that primarily affects the shoulders, hips, and neck, leading to significant stiffness and pain. The management of PMR typically involves the use of corticosteroids, and the first-line treatment is low-dose prednisone. This approach is effective because prednisone quickly alleviates symptoms and can lead to significant improvement in a patient's overall function and quality of life.

Initiating treatment with low-dose prednisone minimizes the risk of potential side effects associated with higher doses of corticosteroids, which can include osteoporosis, weight gain, and increased susceptibility to infections. Furthermore, low-dose therapy provides a balance between achieving symptomatic relief and reducing the likelihood of adverse reactions.

The dosing may be adjusted based on the patient's response to treatment, and many patients find that they can taper the dosage over time as symptoms improve. This method not only addresses the immediate concerns of pain and stiffness but also allows for a careful evaluation of the patient’s condition over time, promoting a thoughtful approach to long-term management.

Other treatment strategies, such as chronic NSAID therapy or physical therapy, may be used as adjunct therapies but are not the mainstay of treatment for PMR. Higher doses of corticosteroids might be necessary for certain situations, such as