PMR is a clinical syndrome whose cause is unknown There is no universally accepted definition  but several classification criteria include patients over the age of 50 years  who have moderate-to-severe aching and stiffness of the neck  torso  shoulders  or proximal regions of the arms  hips  or thighs  of at least one-month duration  with morning stiffness and elevated markers of systemic inflammation such as erythrocyte sedimentation rate (ESR) (3)