Patterns of pain and stiffness over 5 years in polymyalgia rheumatica: results from the PMR Cohort Study

To investigate the anatomical locations of pain and stiffness in people with polymyalgia rheumatica (PMR) and how these compare with the general population.

A total of 739 people with PMR were invited to complete a postal survey at the time of their diagnosis. Respondents were sent further questionnaires after 1, 4, 8, 12, 18, 24 and 60 months. All questionnaires included a body manikin on which participants shaded areas of pain or stiffness lasting >1 day in the last month. The prevalence of pain was calculated in 44 mutually exclusive areas. Responses were compared with similar manikins completed at a single time point by an age- and gender-matched sample from a general population survey.

Completed surveys were received from 652 people with PMR at diagnosis, 244 at 24 months and 197 at 60 months. Pain was reported in a median of 16 sites at diagnosis, with the majority reporting bilateral shoulder (81%) and hip (59%) pain. After 1 month, the median number of pain areas in people with PMR was four-the same as the general population sample-but those with PMR continued to report more bilateral shoulder and hip pain. The converse was true for unilateral pain.

Bilateral pain remains more common in people with PMR than their age- and gender-matched counterparts through the disease course. Causes of this pain could not be attributed but likely include residual disease activity, treatment sequelae and comorbidities. This knowledge will help to direct future investigations to improve quality of life for people with PMR.