What is polymyalgia rheumatica and how is it related?

Polymyalgia rheumatica causes muscle pain and stiffness, especially in shoulders and hips. About 50 percent of people with temporal arteritis also have polymyalgia rheumatica. Both conditions involve inflammation and respond to similar treatments. Having one condition increases your risk of developing the other.

Temporal arteritis

What is Temporal arteritis?

Temporal arteritis is an inflammation of the blood vessels in your temples and scalp. It affects the medium and large arteries that carry oxygen-rich blood to your head. This condition is also called giant cell arteritis because it creates abnormal cells in the artery walls.

The inflammation causes the artery walls to swell and thicken. This swelling narrows the blood vessels and reduces blood flow. When tissues don't get enough oxygen, you may experience pain and other symptoms. Temporal arteritis most often affects people over age 50, especially women.

Left untreated, temporal arteritis can lead to serious complications including vision loss. Early detection and treatment are essential to prevent permanent damage. The good news is that with proper care, most people recover well and avoid long-term problems.

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Symptoms

Common symptoms of temporal arteritis include:

Severe headache, usually in the temples
Scalp tenderness, especially when brushing hair
Jaw pain when chewing or talking
Vision changes, including blurred or double vision
Sudden vision loss in one or both eyes
Fever and fatigue
Unintentional weight loss
Muscle aches, especially in the shoulders and hips
Tender, swollen, or hard temporal arteries

Some people experience mild symptoms at first that gradually worsen. Vision problems require immediate medical attention, as they can signal a medical emergency. Early symptoms may be mistaken for other conditions like migraines or infections.

Causes and risk factors

The exact cause of temporal arteritis is not fully understood. Researchers believe it results from an abnormal immune system response. Your immune system mistakenly attacks the artery walls, causing inflammation. This may be triggered by environmental factors, infections, or genetic predisposition.

Several risk factors increase your chances of developing temporal arteritis. Age is the biggest factor, as it rarely occurs before age 50. Women are two to three times more likely to develop it than men. People of Northern European or Scandinavian descent have higher risk. Having another condition called polymyalgia rheumatica also increases your risk, as about half of people with temporal arteritis have both conditions.

How it's diagnosed

Doctors diagnose temporal arteritis through a combination of physical exam, blood tests, and imaging. Your doctor will check your temples for tenderness and examine your arteries. A sed rate blood test measures inflammation levels in your body. An elevated sed rate strongly suggests temporal arteritis, though other tests may be needed. Rite Aid offers sed rate testing as an add-on to help detect inflammation markers.

Your doctor may also order a temporal artery biopsy to confirm the diagnosis. This involves removing a small piece of the artery for examination under a microscope. Imaging tests like ultrasound or MRI can show artery inflammation and narrowing. Early diagnosis is critical because treatment should begin immediately to prevent vision loss and other complications.

Treatment options

Treatment focuses on reducing inflammation and preventing complications:

High-dose corticosteroids like prednisone, usually started immediately
Gradual tapering of steroid doses over months to years
Aspirin to reduce risk of vision loss and stroke
Calcium and vitamin D supplements to protect bones during steroid use
Regular monitoring with blood tests to track inflammation levels
Eye exams to check for vision changes
Balanced diet rich in anti-inflammatory foods
Regular gentle exercise to maintain muscle strength
Adequate rest and stress management

Most people need treatment for at least one to two years. Some may require longer treatment if symptoms return. Work closely with your doctor to adjust medications and monitor your progress. Never stop steroids suddenly, as this can cause serious problems.

Frequently asked questions

Temporal arteritis causes severe, persistent head pain focused in the temple area with scalp tenderness. Regular headaches rarely cause scalp sensitivity or jaw pain when chewing. Temporal arteritis headaches don't respond well to common pain relievers. If you have new severe head pain over age 50, see a doctor right away.

Yes, untreated temporal arteritis can cause permanent vision loss in one or both eyes. This happens when inflammation blocks blood flow to the optic nerve. About 15 to 20 percent of untreated cases result in blindness. Starting treatment quickly, usually within days of symptoms, prevents most vision complications.

Most people need treatment for one to two years. Your doctor will start with high-dose steroids and slowly reduce the amount over many months. Some people need longer treatment if inflammation returns. Regular blood tests help your doctor know when it's safe to lower your dose.

An elevated sed rate shows that inflammation is present somewhere in your body. The test measures how quickly red blood cells settle in a tube. In temporal arteritis, the sed rate is often very high, sometimes over 50 or even 100. Other conditions can also raise sed rate, so doctors use it along with symptoms and other tests.

Temporal arteritis is not directly inherited, but genetic factors may increase risk. People with Northern European or Scandinavian ancestry are more likely to develop it. Having family members with the condition slightly raises your risk. However, most cases occur in people with no family history.

There is no proven way to prevent temporal arteritis because the exact cause is unknown. Maintaining overall health through good nutrition and regular exercise may help your immune system. The most important prevention step is early detection and treatment to avoid complications. If you're over 50 and notice new severe headaches, see a doctor promptly.

A temporal artery biopsy is a minor surgical procedure done under local anesthesia. The doctor makes a small incision near your temple and removes a tiny section of artery. The tissue is examined under a microscope for signs of inflammation. The procedure takes about 30 minutes and you can usually go home the same day.

Yes, long-term steroids can cause weight gain, bone loss, high blood sugar, and increased infection risk. Your doctor will prescribe the lowest effective dose and monitor you closely. Taking calcium and vitamin D helps protect your bones. Regular exercise and a healthy diet can reduce other side effects.

Yes, temporal arteritis can relapse even after successful treatment. About 25 to 50 percent of people experience flare-ups when reducing steroid doses. Regular monitoring with blood tests helps catch relapses early. If symptoms return, your doctor may need to increase your medication again temporarily.