Polymyalgia Rheumatica
Polymyalgia rheumatica (PMR) is a syndrome characterized by muscle pain in the neck, shoulder girdle, and pelvic girdle, morning stiffness, and systemic features such as fever and an elevated erythrocyte sedimentation rate (ESR).
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Clinical description:
Fixed-site pain, restricted movement, aversion to cold, a pale, swollen tongue with a white or greasy coating, and a wiry, deep, or tight pulse.
In plain language:
- The pain stays in one place rather than moving; pressing or moving the affected area does not change its location.
- Range of motion is limited, and joints may feel stiff when turning, bending, or straightening.
- You may feel sensitive to cold, with discomfort worsening in cold wind or low temperatures.
- The tongue may look pale and enlarged when extended.
- The tongue coating may be white or appear greasy.
- On pulse examination, the pulse may feel taut like a string, or tight when pressed more deeply.
|Treatment Approach
Clinical description:
Dispel cold, eliminate dampness, unblock the channels and collaterals, and relieve pain.
In plain language:
- Dispel cold → Drive out cold from the body or affected area, easing cold-related pain and discomfort that worsens with cold.
- Eliminate dampness → Address excess dampness in the body, easing heaviness, a sticky or sluggish feeling, swelling, and a sense of heaviness in the joints.
- Unblock the channels and collaterals → Promote the flow of qi and blood through the channels and collaterals, with the aim of easing numbness, stiffness, and restricted movement.
- Relieve pain → Directly ease pain and reduce soreness, distending pain, stabbing pain, and pulling discomfort.
|Related Products
The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Pain in the neck, shoulders, and buttock muscles; fixed-site pain with a heavy sensation and restricted movement; fever, dark urine, and dry stools; a red tongue with a yellow, greasy coating; and a slippery or fine, rapid pulse.
In plain language:
- The neck, shoulders, and buttock muscles may hurt, with discomfort when pressed or moved.
- The pain tends to stay in one place rather than move around.
- The affected area may feel heavy or weighed down.
- Range of motion is limited, and turning, bending, or straightening may feel stiff.
- Fever may occur, with an elevated body temperature and a feeling of warmth.
- Urine may look yellow or darker than usual.
- Stools may be dry and difficult to pass.
- The tongue may appear red when extended.
- The tongue coating may be yellow and greasy in appearance.
- On pulse examination, the pulse may feel slippery, or fine and somewhat rapid.
|Treatment Approach
Clinical description:
Clear heat, eliminate dampness, unblock the channels and collaterals, and relieve pain.
In plain language:
- Clear heat → Address internal heat, easing redness, swelling, warmth, sore throat, thirst, and irritability.
- Eliminate dampness → Address dampness in the body or affected area, easing heaviness, stickiness, swelling, discharge, and a heavy feeling in the joints.
- Unblock the channels and collaterals → Promote the flow of qi and blood through the channels and collaterals, with the aim of easing numbness, stiffness, and restricted movement.
- Relieve pain → Directly ease pain and reduce soreness, distending pain, stabbing pain, and pulling discomfort.
|Related Products
The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Fever, night sweats, dry mouth and throat, weight loss, a red tongue with little coating, and a fine, rapid pulse.
In plain language:
- You may have a fever, with an elevated temperature and an uncomfortable feeling of warmth.
- You may sweat during sleep at night; the sweating gradually stops after waking or becoming alert.
- Your mouth and throat may feel dry, causing discomfort when speaking or swallowing.
- You may lose weight and appear thinner.
- The tongue may look red overall when extended.
- The tongue coating may be sparse, thin, or barely visible.
- On pulse examination, the pulse may feel fine and somewhat rapid.
|Treatment Approach
Clinical description:
Nourish yin, reduce fire, cool the blood, and unblock the channels and collaterals.
In plain language:
- Nourish yin → Replenish yin fluids and nourishing substances in the body to provide moisture and nourishment, easing dry mouth and throat, hot flashes, night sweats, and related discomfort.
- Reduce fire → Address internal heat, easing restlessness, feeling hot, thirst, sore throat, and facial flushing.
- Cool the blood → Address heat in the blood aspect, with the aim of easing redness, a tendency to bleed, and a red tongue.
- Unblock the channels and collaterals → Promote the flow of qi and blood through the channels and collaterals and microcirculation, with the aim of easing numbness, soreness, distending pain, and restricted movement.
|Related Products
The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Soreness and pain in the neck, shoulders, and buttock muscles; stiffness and fixed-site pain; restricted movement; a dark complexion; a dark-red tongue or purple spots and patches; a thin white coating; and a wiry, choppy pulse.
In plain language:
- The neck, shoulders, and buttock muscles may feel sore, with discomfort during everyday activities.
- You may feel stiff, with reduced flexibility when turning, bending, or straightening.
- The pain stays in one place rather than moving; pressing the area does not change its location.
- Range of motion is limited, and movements may feel difficult or awkward.
- The face may look dark or dull, with a dark complexion.
- The tongue may appear dark red, or have purple spots or patches.
- The tongue coating may be thin and white.
- On pulse examination, the pulse may feel taut like a string and somewhat rough or uneven.
|Treatment Approach
Clinical description:
Invigorate blood, dispel stasis, transform phlegm, and unblock the channels and collaterals.
In plain language:
- Invigorate blood → Promote blood flow, easing pain, stiffness, and numbness.
- Dispel stasis → Address stagnant blood, easing stabbing pain, fixed-site pain, and swelling.
- Transform phlegm → Address phlegm and turbid substances in the body, easing chest oppression, excessive phlegm, heaviness, and stickiness.
- Unblock the channels and collaterals → Promote the flow of qi and blood through the channels and collaterals, with the aim of easing numbness, pulling pain, and restricted movement.
|Related Products
The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Distending pain in the neck, shoulders, and buttock muscles; distending pain in the flanks and ribs; low mood, irritability, and frequent sighing; a bluish tongue, thin white coating, and wiry pulse.
In plain language:
- The neck, shoulders, and buttock muscles may feel distended and painful, with discomfort when pressed or moved.
- You may feel distending pain in both flanks, with a feeling of pressure or oppression along the sides of the chest and ribs.
- You may experience persistent low mood and feel emotionally constrained.
- You may become irritable and angry easily, even in response to minor triggers.
- You may sigh frequently and involuntarily, with a feeling of tightness in the chest and an urge to sigh.
- The tongue may look bluish or dusky when extended.
- The tongue coating may be thin and white, without appearing thick or greasy.
- On pulse examination, the pulse may feel taut like a string.
|Treatment Approach
Clinical description:
Soothe the liver, relieve constraint, regulate qi, and relieve pain.
In plain language:
- Soothe the liver → Ease constrained liver qi, with the aim of reducing distending pain in the flanks and ribs, low mood, and irritability.
- Relieve constraint → Address stagnation of qi, easing discomfort or oppression in the chest and flanks, a sensation of something stuck in the throat, and feelings of frustration.
- Regulate qi → Help regulate the movement and flow of qi, easing fullness, shifting pain, and pulling discomfort.
- Relieve pain → Directly ease pain and address pain and restricted movement associated with impaired qi flow.
|Related Products
The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Soreness and pain in the neck, shoulders, and buttock muscles, accompanied by a pale complexion lacking luster, soreness and weakness of the lower back and knees, aversion to cold and cold limbs, clear, copious urination, loose stools, a pale-red tongue with a white coating, and a deep, fine or fine, rapid pulse.
In plain language:
- The neck, shoulders, and buttock muscles may feel sore, with noticeable discomfort during movement or when pressed.
- The complexion may appear pale and dull, without a healthy flush.
- The lower back and knees may feel sore, weak, and lacking strength, making walking or exertion difficult.
- You may feel sensitive to cold, with cold limbs and greater discomfort in low temperatures.
- Urine may be pale and more abundant than usual, with urination lasting longer.
- Stools may be loose, soft, and poorly formed, with a lingering sense of incomplete evacuation.
- The tongue may appear pale red when extended, with a white coating.
- On pulse examination, the pulse may be felt more clearly only with deeper pressure and may be fine, or fine and somewhat rapid.
|Treatment Approach
Clinical description:
Nourish and tonify the liver and kidneys, unblock the channels and collaterals, and relieve pain.
In plain language:
- Nourish and tonify the liver and kidneys → Nourish the essence, blood, yin, and yang of the liver and kidneys, with the aim of addressing soreness and weakness in the lower back and knees, dizziness, tinnitus, fatigue, and other symptoms, and supporting physical strength and recovery.
- Unblock the channels and collaterals → Promote the flow of qi and blood through the channels and collaterals and microcirculation, with the aim of easing numbness, stiffness, and restricted movement.
- Relieve pain → Directly ease pain and reduce soreness, distending pain, stabbing pain, and pulling discomfort.
|Related Products
The following products are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
References
- Chinese Society of Rheumatology. Guidelines for the diagnosis and treatment of polymyalgia rheumatica and giant cell arteritis[J]. Chinese Journal of Rheumatology, 2011, 15(5): 348-350.
- Shang Guilian, Liu Jianhua. Advances in the diagnosis and treatment of polymyalgia rheumatica[J]. Journal of Internal Intensive Medicine, 2015, 21(2): 146-151.
- Gary S. Firestein, Ralph C. Budd, Edward D. Harris, Jr., et al. Kelley’s Textbook of Rheumatology[M]. 8th ed. Translated by Li Zhanguo and Tang Fulin. Beijing: Peking University Medical Press, 2011: 1493-1514.