I have PMR, and so do my mom and aunt... when first diagnosed, we had many questions about PMR for which we could not find good answers.
I have PMR, and so does my mom, and so does my aunt... thankfully, we all had access to decent doctors, but still it was hard to find clear answers even to the simplest questions, like "when will it end?"
Even with ample access to doctors, resources, and the internet, we don't know exactly why our bodies are attacking themselves, what we can do to help ourselves (besides taking prednisone, which merely masks symptoms), or when (or if!) PMR will ever end.
Below, you'll find the best answers I could find. These are all the answers—from GP doctors, rheumatologists, researchers, and other experts in the field.
Below, you'll find answers to these questions:
- Is there a cure for PMR?
- How long will it last?
- What about PMR pain? Does it ever end?
- What causes PMR, exactly?
- Are there any alternative therapies or treatments for inflammation?
- Will diet and exercise help control PMR symptoms, and can symptoms be controlled by diet and exercise only?
- What is inflammation, anyway?
Use this list to generate a discussion with your doctor. For more answers, read Difficult Questions About the Polymyalgia Rheumatica (PMR) Diagnosis.
Is there a cure for PMR?
There is simply no cure for PMR. Just as no one knows what causes it, there is no cure for it, either—although you may experience temporary or permanent remission (either with or without corticosteroid use), and if you start taking corticosteroids, your symptoms may lessen within 24-48 hours.
Your symptoms might lessen or end but no, there is no cure for PMR. Doctors will try to help you manage the pain, but since they don't know what causes it, they also don't know how to cure it.
How long will PMR last?
Nobody knows precisely when of if it will end, but for most people, the disease is "self-limiting," with an initial incident that lasts from 1 to 5 years.
When I asked my GP doctor, she told me that PMR is chronic, meaning it may persist forever. I didn't like that answer, so I got another opinion: I asked my rheumatologist the same question, she said most of her PMR patients recover in about 3 years... but a few unlucky ones may continue to battle symptoms for the rest of their lives. (Basically the same answer, only worded differently.)
Does PMR ever end?
Although most people do go into permanent remission, many do see relapses and flare-ups, sometimes years after the first symptoms.1
What about PMR pain? Does it ever end?
Since we don't know what causes PMR, we often associate it with its main symptom—pain—instead of thinking of it as an inflammatory disease. So for most sufferers, PMR = its aches, pain, stiffness, and other symptoms.
- Those who take prednisone won't get rid of their pain entirely, but they can often control the dosage sufficiently to alleviate most of the pain, and the pain usually lasts, on and off, for 1 to 5 years.
- Those who look for other, non-steroidal treatments will likely have less success controlling the pain, but its duration is the same: 1 to 5 years.
My experience: I was diagnosed in July of 2018 at age 52. I chose not to take steroids but instead to change my diet and exercise patterns. By July of 2020, most of my pain and symptoms were gone. So my length of pain was slightly below average: I have heard of some controlling pain much more quickly, and some who suffer much longer than I did. Still, I remind myself that relapses do happen.
When I asked my GP doctor, she said PMR is chronic and may last forever. I didn't like that answer, so I asked my rheumatologist, who said most of her PMR patients recover in about 3 years, although a few unlucky ones may continue to battle symptoms for the rest of their lives.
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What causes PMR?
Nobody knows what causes PMR. There are many theories—it's likely related to the aging process, perhaps it's genetic, maybe it's caused by a virus or an infection of some sort—but we don't know for certain the cause. Experts believe that things like smoking, obesity, alcohol, and chronic stress contribute to chronic inflammation, but still, nobody knows for sure.
What are alternative therapies or treatments for PMR?
Some call corticosteroids (like prednisone) "cures." But although they do mask the pain, they do nothing to identify or treat the underlying cause or condition. (If you're not sure you want to use prednisone, you might like to read I Don't Want to Take Prednisone for PMR: Are Corticosteroids Necessary?)
Some people report success with the following:
- Diet: some believe that changes in diet can "cure"—or at least alleviate—PMR. The Anti-Inflammatory, Mediterranean, Keto, and Paleo diets are all anecdotally helpful. Controlling sugar and gluten may help.
- Exercise: many say that they can control pain with exercise: although it feels counterintuitive (and even injurious!) to move when moving hurts so much, many report that they are able to ward off or lessen their pain through gentle movement and exercise.
- Anti-Inflammatories: many claim that NSAIDS, allergy-avoidance, curcumin, ginger, omega-3 fatty acids (fish oil), and an anti-inflammatory diet can help. For research and studies about spices, read Chronic diseases, inflammation, and spices: how are they linked?
- CBD and THC: Many PMR-sufferers report relief using cannabis-based products for easing pain and reducing inflammation.
Will diet and exercise help with PMR symptoms?
Can PMR be controlled by diet and exercise? That depends on many factors, including your levels of inflammation, your tolerance to pain, your age, and how healthy you are.
Exercise is extremely important for PMR. Regular exercise is essential to maintain joint flexibility, muscle strength, and function. A consistent exercise routine helps with managing pain and maintaining joint flexibility and muscle health.
Other holistic things that might help:
- Physical therapy. A physical therapist can help you find specific exercises that help alleviate pain and prevent bone and muscle loss.
- Diet. My rheumatologist recommended a Mediterranean diet. A 2018 study found that participants following this diet had lower markers of inflammation. Many people report controlling or easing symptoms by avoiding certain foods and/or following an anti-inflammatory diet.
- CBD/THC. For the first year after diagnosis, sublingual doses of CBD/THC helped me manage the pain flareups.
- Supplements. Certain supplements may help to lessen inflammation. Omega-3s, curcumin and ginger may all help to reduce inflammation. Several spices may also help with chronic inflammation and inflammatory disease, including turmeric, ginger, garlic, and cayenne.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs like aspirin, ibuprofen (Advil), and naproxen (Aleve), can help reduce inflammation and pain, but long-term use can be dangerous. My doctor said I could take 3 Aleves (220 mg each) per day and after a year, we'd discuss alternatives.
Can PMR be controlled by diet and exercise alone?
That still depends on your levels of inflammation, tolerance to pain, age, how healthy you are, and other variables. Many people claim to have treated PMR with diet and exercise alone, although there have been no studies. But even if you don't control it completely, diet and exercise will certainly help.
My own experience: After two years of exercise and healthy eating (but no steroids!), I was able to bring my inflammation levels down and control the pain. The last time I saw my doctor, my blood tests showed relatively normal levels of inflammation. Today, my shoulders are crunchy when I move certain ways, but I only ache on rare occasions and I haven't had a full flare-up for a long time.
Exercise is extremely important for PMR. Regular exercise is essential to maintain joint flexibility, muscle strength, and function. Regular exercise will help control both physical and emotional symptoms.
What is inflammation, anyway?
PMR is an inflammatory disorder. What does that mean?
Inflammation is how your body fights back. Whenever something attacks (an infection or toxin, for example, or if you get injured), your body sends white blood cells, antibodies, proteins, and increased blood flow to fight it. Your immune system triggers the release of antibodies and proteins, and increases the blood flow to the affected area. Usually, if everything is working normally, your body will only be inflamed for a few hours or days.
However, with chronic inflammation (like PMR), the response lingers for weeks, months, or years, putting your system in a constant state of alert.
What about you?
1Polymyalgia rheumatica can recur years after discontinuation of corticosteroid therapy: Docken WP. Clin Exp Rheumatol. Brigham and Women's Hospital, Boston, MA; Feb 2009
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.