How polymyalgia rheumatica is diagnosed

The clinician will ask when stiffness began, whether it is worse after waking or resting, and how it affects dressing, reaching, walking, or rising from a chair. Polymyalgia rheumatica typically centres on the shoulders and hips, while true muscle power may be preserved even when pain makes movement difficult.

The examination may include shoulder and hip movement, muscle strength, joints, pulses, skin, and a neurological check. Blood tests can show inflammation and help identify anaemia or other clues, but no single result proves the diagnosis. Other inflammatory, endocrine, medication-related, and mechanical conditions may need consideration.

Write down the date symptoms started, areas affected, stiffness after waking, fatigue, fever, weight change, headaches, jaw symptoms, and any visual change. Bring a medicine and supplement list, details of previous illnesses, and information about family history. Do not start leftover steroids before assessment unless a clinician instructs you, because they can alter findings and have important effects.

If treatment is started, the clinician may review how pain and stiffness respond, alongside examination and follow-up tests. Physiotherapy can be considered for strength and function once the medical plan is clear.

Seek urgent medical help for a new severe headache, scalp tenderness, pain in the jaw or tongue while chewing, or any blurred, double, or lost vision. These symptoms can occur with associated artery inflammation. Sudden speech problems, facial drooping, or one-sided weakness require emergency care.

Which features make polymyalgia rheumatica more or less likely? What blood tests or other assessments do I need? Which conditions are being ruled out? How will you judge improvement and monitor treatment?