A large proportion of elderly patients presenting to the clinic with complaints of persistent neck and shoulder discomfort, or lumbar and hip pain. No clear pathological signs are seen after a detailed physical examination, and although there are associated cervical metaplasia and lumbar metaplasia on the imaging films, their imaging presentation does not match the symptoms and does not explain all the conditions. Today we will tell you about a lesser known disease – rheumatic polymyalgia. Rheumatic polymyalgia is common in the elderly and is a syndrome characterized clinically by persistent painful stiffness in the neck, scapular girdle, and pelvic girdle muscles. Diagnosis: 1. Elderly people over 50 years old; 2. Neck, shoulder, low back or generalized stiffness for more than 4 weeks; 3. Blood sedimentation > 40 mm/h; 4. Good response to low-dose corticosteroid therapy. Clinical manifestations 1. Systemic symptoms such as low fever, fatigue, lethargy and weight loss. 2. The typical clinical manifestations are symmetrical muscle pain and stiffness in the neck, scapular girdle or proximal pelvic girdle. It may also be unilateral or limited to a certain group of muscles. The stiffness and pain are obvious in the morning or when moving again after rest. In acute onset, every complaint of going to bed at night is fine, and in the morning the whole body wakes up with unbearable pain and stiffness. The symptoms of rheumatic polymyalgia are morning stiffness and myalgia, which gradually disappear 1 to 2 hours after waking up in the morning, and the stiffness is obvious after resting. Contracture of the muscles around the shoulder or hip joint can cause joint movement disorders, and there is no redness, swelling or heat in the affected muscles. The most prominent laboratory abnormalities are increased blood sedimentation (40-50 mm/h) and elevated C-reactive protein. Rheumatoid factor, antinuclear antibodies, serum complement, and serum myosin activity were normal. Electromyography showed no signs of myogenic or neurogenic damage. Treatment For PMR with mild symptoms or without vasculitis, especially those with negative temporal artery biopsy, NSAIDs such as enteric indomethacin 25mg, 2-3 times/d and diclofenac (Fotaralin) (25mg, 2-3 times/d) can be tried first to control the symptoms such as myalgia and headache. Although NSAIDs can partially relieve the symptoms, they have no efficacy in stopping the complications of vasculitis. Therefore, short-acting corticosteroids such as prednisone are generally considered to be the first choice for this disease. Generally, 10-20 mg/d of prednisone is used, and symptoms are significantly reduced the next day or within a few days. If there is still no efficacious response in 1 to 2 weeks, attention should be paid to the coexistence with GCA, or other diagnoses should be considered. For those who respond to prednisone treatment, dose reduction can generally be started after 2-4 weeks of maintenance, and the total efficacy is determined according to the withdrawal response; a few patients must be treated with a small dose (7.5 mg/d) for 1 to 2 years of maintenance.