Polymyalgia rheumatica (PR) and rheumatoid arthritis (RA) both cause joint pain, but in RA, a person’s immune cells attack the lining of the joints, as well as other parts of the body, such as the eyes.

These characteristics do not apply to PR. Additionally, PR only lasts roughly 1–5 years. In contrast, RA is a progressive condition that can lead to disability and a higher risk of death.

Keep reading to learn more about PR versus RA, including symptoms, diagnosis, and treatments.

An older woman's hands resting on her knee. She wears an orange printed dress.Share on Pinterest
1423972357 Light Design/Getty Images

RA is an inflammatory condition in which the immune system mistakenly attacks the synovium, which is the lining of joints. Over time, it leads to destruction of the affected joints, resulting in inflammation, pain, and reduced mobility. RA can also affect other parts of the body, such as the eyes and blood vessels.

PR is an inflammatory condition that experts believe could be autoimmune, meaning it is potentially the result of the immune system attacking healthy tissue. However, unlike RA, PR does not result in the same damage to joints, and it does not affect other parts of the body.

Consequently, RA is more serious than PR. It is systemic, meaning it affects the whole body, and it is a lifelong condition, whereas PR can go away within a few years.

Although some symptoms in PR and RA overlap, there are differences, as RA causes much broader effects.

joint pain and swelling, typically affecting small joints in the hands or feet firstjoint pain and swelling, often in the neck, shoulders, upper arms, hips, buttocks, or thighs
morning stiffness that lasts 30 minutes or longermorning stiffness or stiffness after inactivity
affects more than one joint and is often symmetrical, affecting joints on both sides of the bodyaffects more than one joint or body part
low grade feverfever
potential weight gain that can occur if a person finds RA makes it difficult to stay physically activeweight loss
skin symptoms, such as small lumps on body partsloss of appetite
eye redness, pain, or sensitivity to light
mouth dryness or gum inflammation
lung inflammation or scarring, which could lead to shortness of breath
blood vessel inflammation
decreased red blood cells
heart inflammation, which can damage heart muscles

PR can co-occur with giant cell arteritis, a condition involving inflammation of the lining of arteries that can lead to very serious health events.

Blood tests for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA) are key in the diagnosis of RA. These substances are autoantibodies, which attack a person’s own tissue.

RF is an autoantibody that is specific to RA. If a person has RA symptoms, and both autoantibodies, it indicates they have the condition.

Conversely, PR is not associated with specific antibodies, Instead, doctors can test for the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

Doctors base a PR diagnosis on a high ESR and high CRP levels, which indicate inflammation is present, along with the main symptoms.

Some of the same medications can treat PR and RA. However, because RA has more widespread effects, it requires a broader spectrum of drug and non-drug interventions.

PR treatment

The main treatment for PR is corticosteroids, which are anti-inflammatory medications that reduce stiffness and pain. Prednisone (Deltasone) is an example. Doctors prescribe a low dose, and symptoms usually improve rapidly.

For mild cases, doctors occasionally recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin), to help relieve pain and inflammation. Gentle exercise and rest also play a role in reducing stiffness and aiding recovery.

In some situations, a doctor may prescribe a type of drug known as a disease-modifying antirheumatic drug (DMARD). These drugs also reduce inflammation and may be effective in people whose condition does not respond to steroids, or who have severe or unusual symptoms.

RA treatment

Medication options for RA include the following:

  • NSAIDs: As with PR, these drugs are used to help reduce inflammation and pain.
  • DMARDs: These medications block inflammation to help preserve joints. They are available as biological varieties, which living cells produce, and nonbiological varieties, which scientists make in a laboratory. An example of a biologic is etanercept (Enbrel), and a nonbiologic example is methotrexate (Trexall).
  • Corticosteroids: In some cases, doctors also prescribe corticosteroids for RA, but long-term use has a range of risks.

Other treatments can include:

  • physical therapy
  • occupational therapy
  • surgery

Below are some answers to frequently asked questions about PR and RA.

Can PR turn into RA?

There is no current evidence that PR can turn into RA. The conditions have different underlying mechanisms.

Can you have both PR and RA?

Presently, there is no research suggesting that PR raises the risk of RA, or vice versa. This suggests it may be unlikely for someone to have both.

Does PR or RA go away?

PR does. It typically lasts 1–5 years. In contrast, RA does not go away. It is a progressive condition that currently does not have a cure.

Which is worse?

RA lasts longer and has more impactful effects on the body than PR.

When PR is promptly treated, a person typically has an excellent outlook. Their life expectancy is not significantly different than that of the general population.

Conversely, within 10 years of diagnosis, RA can lead to disability that affects employment and the performance of activities of daily living. It also increases the risk of death.

Comparing polymyalgia rheumatica (PR) and rheumatoid arthritis (RA) shows differences in symptoms, diagnosis, treatment, and a person’s outlook.

Both PR and RA cause joint pain and stiffness, but RA can also affect the skin, eyes, mouth, blood vessels, and heart. The presence of certain autoantibodies indicates RA, while the presence of inflammatory substances suggests a PR diagnosis.

PR treatment involves corticosteroids. RA treatment includes other drug and non-drug treatments that a person may need to continue long-term to help prevent joint damage.

If a person feels they may have PR or RA, it is important that they talk with a healthcare professional to get a proper diagnosis and treatment.