PMR Basics: PMR vs “Polymyalgia” vs “Myalgia” (What’s the Difference?)

TL;DR: PMR is a specific diagnosis with a classic pattern—both shoulders and/or hips, morning stiffness ≥ 45 minutes, age ≥ 50, and often high ESR/CRP. “Polymyalgia” just means “many muscle pains,” and “myalgia” means muscle pain in general. Getting the name right matters, because PMR has a proven work-up and treatment plan.

Quick definitions

• Myalgia: a symptom — muscle pain from any cause (overuse, infection, medications like statins, etc.).
• Polymyalgia: many areas of muscle pain (still just a description, not a diagnosis).
• Polymyalgia rheumatica (PMR): a disease with a typical pattern and criteria that help doctors classify it and rule out look-alikes.

The PMR pattern doctors look for

• Age 50 or older with new aching and stiffness in both shoulders (often neck/upper arms) and often both hips/thighs
• Morning stiffness ≥ 45 minutes
• Blood tests showing inflammation (often high ESR/CRP)
• Other diseases reasonably ruled out
• Sometimes ultrasound evidence of bursitis or tendon sheath inflammation around the shoulders/hips
  These features, especially the shoulder/hip + morning stiffness combo, separate PMR from vague “polymyalgia.”

Look-alikes your clinician may consider

• Elderly-onset rheumatoid arthritis, rotator cuff disease, cervical/lumbar spine problems, hip osteoarthritis, inflammatory muscle disease, thyroid problems, statin-related muscle symptoms, and infections. Imaging and lab tests help sort these out.

Why labels matter

Calling everything “polymyalgia” can delay the right care. PMR has evidence-based guidance on steroids, tapering, and when to consider methotrexate or IL-6 blockers in hard-to-treat cases. Getting to the correct label means a safer plan with fewer relapses and side effects.