Hip & Thigh

What It Is

Polymyalgia rheumatica (PMR) is an inflammatory condition that causes pain, stiffness and inflammation in the muscles around the shoulders, neck and hips (NHS, 2023a), and sometimes the thighs (Arthritis UK, n.d.). The main symptom is muscle stiffness in the morning that lasts longer than 45 minutes (NHS, 2023a). Symptoms often come on quickly, over a week or two (Arthritis UK, n.d.). PMR can start at any age from 50, but most people who develop it are over 65, and it is very rare in people younger than 50 (NHS, 2023a; Arthritis UK, n.d.).

The term comes from poly = many and myalgia = muscle pain (Arthritis UK, n.d.), with rheumatica referring to a rheumatic (joint and muscle) condition. Hence, many muscle and joint pains.

The main treatment is a steroid medicine called prednisolone, prescribed by your doctor (NHS, 2023a; NHS, 2023b). This is covered in the list of treatments to discuss with your family doctor or nurse practitioner below. The condition is related to another inflammatory condition known as giant cell arteritis (also called temporal arteritis), in which arteries in the head and neck become inflamed. Up to 1 in 5 people with PMR develop it, and it's possible to have both conditions at the same time (NHS, 2023a).

Polymyalgia Rheumatica Anatomy

The muscular system controls the movement in the human body. In PMR, the muscles mainly affected are those around the shoulders, neck and hips (NHS, 2023a).

Most of the skeletal muscles are attached to two different bones using tendons. The tendons are a tough band of connective tissue with strong collagen fibers firmly attaching the bones to the muscles. Tendons are under a lot of stress when the muscles are pulling on them, so they are quite strong and are woven into the bone and muscle coverings.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Polymyalgia Rheumatica

1. Calcium and Vitamin D

Steroid treatment can make your bones thinner and more likely to break (osteoporosis). Arthritis UK advises making sure you get enough calcium and vitamin D, and doing some weight-bearing exercise such as walking, to reduce this risk. It says a pint of milk a day, together with other foods that contain calcium, should be enough for most people, and that everyone is recommended to take a vitamin D supplement in the autumn and winter months (Arthritis UK, n.d.). (This medicine information comes from Arthritis UK, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Therapy and Keeping Active

Alongside your medical treatment, I can help you keep moving, with gentle exercises and hands-on work for stiff, aching muscles. See the My Approach tab for how I work.

Physiotherapy, including range of movement exercises for the shoulders, can help to reduce pain and maintain mobility (Arthritis UK, n.d.), and an individual exercise programme and early physiotherapy are recommended (Harkins et al., 2025). You'll need to find the right balance between rest and activity: too much exercise is likely to make symptoms worse, but activity usually helps to ease pain and stiffness in the muscles. A hot bath or shower can help to ease pain and stiffness first thing in the morning or after exercise (Arthritis UK, n.d.).

3. Pain Relief

Arthritis UK says painkillers such as paracetamol, or short courses of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, can help ease pain and stiffness, and can be taken at the same time as steroid tablets (Arthritis UK, n.d.). (This medicine information comes from Arthritis UK, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Steroid tablets (prednisolone): the main treatment for PMR. Symptoms usually improve within a few days, the dose is reduced gradually over time, and most people need treatment for 12 months to 2 years. Never stop taking steroids suddenly unless your doctor tells you it is safe to stop (NHS, 2023a; NHS, 2023b).
Reviewing the diagnosis: if your symptoms do not improve as expected on steroids, your doctor may adjust treatment or look again for another cause (Bin Mahmood et al., 2020).
Bone-protecting medicines: medicines called bisphosphonates can slow down or prevent bone loss while you are taking steroids (Arthritis UK, n.d.).
Disease-modifying anti-rheumatic drugs (DMARDs): medicines such as methotrexate may be prescribed alongside steroids if symptoms keep coming back or it is hard to reduce the steroid dose (Arthritis UK, n.d.; NHS, 2023b).

How I can help (see the My Approach tab)

Gentle hands-on care for stiff shoulders, neck and hips

Range of movement exercises and a gentle exercise programme

Help with pacing and staying active

Tips

Eat a balanced diet loaded with vegetables, fruits, low-fat meats and whole grains. Include foods that contain calcium, and try to maintain a healthy weight (Arthritis UK, n.d.).
Discuss an exercise regimen that will work for you to help maintain a healthy weight and strengthen muscles and bones. Walking is usually the most suitable weight-bearing exercise for people with PMR (Arthritis UK, n.d.). I can help you put a regimen together (see the My Approach tab).
Sitting for a long time can cause stiffness, so on long journeys stop from time to time to stretch your shoulders, arms and legs (Arthritis UK, n.d.).
Use grocery carts, shower grab bars, reaching aids and other assistive devices to help make normal, everyday tasks simpler.
Smoking or drinking a lot of alcohol increases your risk of osteoporosis (Arthritis UK, n.d.).
If you take steroids, carry a steroid card so other health professionals know you are taking them (NHS, 2023b; Arthritis UK, n.d.).

Treatment

My Approach

Your doctor leads the treatment of polymyalgia rheumatica, usually with steroid tablets. I work alongside it to help you stay moving and to ease the stiffness and aching around your shoulders, neck and hips. If your symptoms are new and haven't been checked, please see your family doctor or nurse practitioner before we start.

I check in at the start of every session and adjust to how you're feeling. On worse days, including flare-ups, sessions are gentler and shorter and I work around the sorest areas.

Hands-On Care

Warm applications and gentle massage for the shoulders, neck, hips and thighs
Easy, comfortable joint movement and gentle stretching for stiff shoulders and hips
Lighter pressure and careful positioning, because long-term steroids can thin the bones and skin

Staying Active

Gentle range of movement exercises for the shoulders and hips to do at home
Walking and light strength work, built up gradually, to help protect your bones and muscles
Pacing: finding the balance between rest and activity, so exercise eases stiffness rather than flaring it

If you get a sudden severe headache, scalp or temple tenderness, jaw pain when eating, or any change in your sight, call 911 or go to the emergency room.

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly or every other week, with a reassessment at about 4 to 6 weeks, then less often. Steroids usually ease symptoms within a few days, and most people need treatment for 12 months to 2 years, so I fit our sessions around your doctor's plan as the dose is reduced.

What I Focus On

Working Alongside Your Medical Care

Gentle Hands-On Relief

Shoulder & Hip Mobility

Pacing

Bone-Friendly Exercise

Please read

When to See a Doctor First

When to get urgent help

Giant cell arteritis needs treatment straight away, as it can cause loss of eyesight or a stroke. If you have a severe headache that comes on suddenly, tenderness of the scalp or temples, pain in the jaw or tongue when eating or talking, or problems with your sight such as blurred or double vision, call 911 or go to the emergency room at your nearest hospital (NHS, 2023a; Arthritis UK, n.d.).

Diagnosis is key. PMR is more common in women than men (NHS, 2023a), and it is most common in people of Northern European descent (Bin Mahmood et al., 2020). Patients report aching and stiffness in several areas of the body, often worst around the hips and shoulders. Symptoms are usually bilateral (i.e. on both sides at the same time) (Arthritis UK, n.d.). Patients often report waking up with pain and stiffness in the morning, and the pain may wake them at night (Arthritis UK, n.d.). See your family doctor or nurse practitioner if you have pain and stiffness for more than a week (NHS, 2023a).

Sources

References

NHS (2023a) Polymyalgia rheumatica. Available at: https://www.nhs.uk/conditions/polymyalgia-rheumatica/ (Accessed: 7 October 2026).
NHS (2023b) Polymyalgia rheumatica: treatment. Available at: https://www.nhs.uk/conditions/polymyalgia-rheumatica/treatment/ (Accessed: 7 October 2026).
Arthritis UK (formerly Versus Arthritis) (n.d.) Polymyalgia rheumatica (PMR). Available at: https://www.arthritis-uk.org/information-and-support/understanding-arthritis/conditions/polymyalgia-rheumatica-PMR/ (Accessed: 7 October 2026).
Bin Mahmood, S., Nelson, E., Padniewski, J. and Nasr, R. (2020) 'Polymyalgia rheumatica: an updated review', Cleveland Clinic Journal of Medicine, 87(9), pp. 549–556. doi: 10.3949/ccjm.87a.20008
Harkins, P., Cowley, S., Burke, E. et al. (2025) 'Modern management of isolated polymyalgia rheumatica', Rheumatology and Therapy, 12(6), pp. 1017–1041. doi: 10.1007/s40744-025-00797-z

Massage therapy · Kitchener–WaterlooPolymyalgia Rheumatica

What It Is

Polymyalgia Rheumatica Anatomy

Self-Care & Treatment

How to Treat Polymyalgia Rheumatica

1. Calcium and Vitamin D

2. Therapy and Keeping Active

3. Pain Relief

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Care

Staying Active

Typical Course

When to See a Doctor First

When to get urgent help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooPolymyalgia Rheumatica

What It Is

Polymyalgia Rheumatica Anatomy

Self-Care & Treatment

How to Treat Polymyalgia Rheumatica

1. Calcium and Vitamin D

2. Therapy and Keeping Active

3. Pain Relief

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Care

Staying Active

Typical Course

When to See a Doctor First

When to get urgent help

References

Related Conditions

Compartment Syndrome – Thigh/Buttocks

Developmental Dislocation (Dysplasia) of the Hip (DDH)

Femoral Anteversion

Femoral Fracture

Book a session