What is the cornerstone treatment for polymyalgia rheumatica?

Polymyalgia rheumatica (PMR) is an inflammatory condition characterized by muscle pain and stiffness, particularly in the shoulders and hips. The cornerstone of treatment for PMR is the use of corticosteroids, with prednisone being the most commonly prescribed. Corticosteroids effectively reduce inflammation and alleviate symptoms such as pain and stiffness, leading to a rapid improvement in the patient's condition.

Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be utilized for symptomatic relief, but they are not as effective as corticosteroids for managing the underlying inflammation associated with PMR. Therefore, while NSAIDs can be part of the treatment plan, the mainstay remains the use of prednisone.

The other options do not address the inflammatory nature of PMR sufficiently. Exercise and physical therapy can be beneficial as adjuncts to improve function and mobility, but they do not manage the underlying inflammation. Antibiotics and surgery do not play a role in treating PMR, as it is not caused by an infection or structural problem. Cold compresses may provide temporary relief of muscle soreness but do not have an impact on the inflammation that characterizes PMR.

Hence, the primary and most effective treatment approach for PMR involves the use of NSAIDs alongside prednisone to manage both symptoms