Does Cymbalta help with polymyalgia? (+7 options)

This article will discuss whether Cymbalta can help with polymyalgia rheumatism (PMR). It will explain the mechanism by which Cymbalta can improve pain in this condition.

Furthermore, the article will explore case studies where Cymbalta was used for polymyalgia rheumatism. It will also mention the possible side effects of using this drug for PMR. Finally, this article will discuss other medications that are approved for treating PMR.

Does Cymbalta help with polymyalgia?

Cymbalta may help with polymyalgia rheumatism (PMR) pain in certain cases only. However, it is not one of the most commonly used medications for this condition.

In the algorithm for managing polymyalgia rheumatism, corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs) are the recommended medications for polymyalgia rheumatism-associated pain and inflammation. Cymbalta is not a specifically recommended treatment for PMR’s pain [1].

However, Cymbalta has been approved for the treatment of fibromyalgia, a condition that can often coexist with polymyalgia rheumatism, particularly in elderly patients. Moreover, it is effective in reducing musculoskeletal pain in osteoarthritis, which is also a condition that is characterized by joint pain.

Thus, Cymbalta may help in managing the pain of PMR, especially in patients who are also suffering from fibromyalgia [2]. People’s responses to medications differ, and Cymbalta won’t help with PMR symptoms in all people.

Therefore, you must not take Cymbalta for PMR without consulting with a doctor. They will assess your medical history and determine the most suitable treatment options for polymyalgia rheumatism and any other conditions you may have.

How can Cymbalta help with PMR-associated pain?

Duloxetine generally improves pain, including neuropathic pain, through a variety of mechanisms. It is a serotonin-norepinephrine reuptake inhibitor. Thus, it increases serotonin and norepinephrine.

One of the mechanisms by which pain occurs is through an imbalance between pro-pain chemicals, such as substance P and glutamate, and anti-pain neurotransmitters, such as serotonin and noradrenaline.

Since duloxetine increases both serotonin and noradrenaline, it helps regulate the ratio between pro-pain substances and anti-pain neurotransmitters. Additionally, duloxetine was found to inhibit neuronal cell firing and decrease the response of pain receptors to pain signals.

Due to its efficiency in treating pain, it’s been indicated for the management of diabetic neuropathy, fibromyalgia, and osteoarthritis-related bone and joint pain.

What does research suggest?

Polymyalgia rheumatism and fibromyalgia share several similar symptoms. In some cases, particularly in elderly patients, they may coexist and cause increased general pain.

For example, there’s a case study where a patient with PMR visited a hospital with severe general pain. The physicians diagnosed her with fibromyalgia and prescribed pregabalin, which helped reduce her pain [4].

However, a month later, she returned with buttock pain and fever, which was determined to be an exacerbation of her PMR. Additionally, five months later, she reported intensifying general pain, attributed to a fibromyalgia flare-up [4].

After she was prescribed duloxetine, all her pain and symptoms improved. Thus, duloxetine may be effective in managing pain for individuals with polymyalgia, particularly those who are concurrently suffering from fibromyalgia [4].

In another case study, a female patient with a presumed diagnosis of polymyalgia rheumatism visited a physician for an infection. During the medical history assessment, it was discovered that she had been misdiagnosed with PMR instead of fibromyalgia for three years [5].

Subsequently, she was prescribed duloxetine, which resulted in significant pain relief. Remarkably, after starting duloxetine, the patient experienced a pain-free period of one year [5].

What are the side effects of using Cymbalta for PMR?

Before considering administering Cymbalta for PMR, it is important to know the potential side effects. Here are some common side effects of Cymbalta [2]:

The less common side effects include loss of appetite, vision problems, weight loss or weight gain, migraines, sexual dysfunction, and difficulty urinating. Furthermore, rare yet serious side effects include serotonin syndrome, hallucinations, heart rhythm problems, and liver problems.

What other medications can help with PMR?

To effectively manage polymyalgia rheumatism, it is important to take medications that manage pain and inflammation associated with the disease, in addition to taking drugs that treat the disease itself, which are known as disease-modifying antirheumatic drugs. [1].

Medications for pain and inflammation 

Drugs that treat the symptoms and pain of PMR include [1]:

  • 10 mg of prednisone per day is the most frequently prescribed management option for polymyalgia rheumatica. It effectively reduces inflammation and provides relief from pain and stiffness.
  • If needed, nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, may be added to prednisone to reduce pain and inflammation.

Disease-modifying antirheumatic Drugs (DMARDs)

DMARDs work by modulating the immune system and suppressing inflammation. The most commonly used DMARDs are discussed below:

Name of DMARD Important side effects or contraindications
Methotrexate is the first-line DMARD for treating polymyalgia rheumatism It shouldn’t be used by pregnant or breastfeeding women, people with liver disease, alcoholism, or immunodeficient individuals.
Sulfasalazine can be used in case methotrexate isn’t effective enough, and it’s also safe for pregnant women. It shouldn’t be administered by people with sulfonamide allergy.
Hydroxychloroquine can be used as an add-on to methotrexate if it isn’t effective enough. Doctors may only recommend hydroxychloroquine monotherapy in mild cases.

 It is important to know that it can cause vision changes and gastrointestinal side effects.

Leflunomide can also be used if methotrexate doesn’t work. It is similarly contraindicated in pregnancy, breastfeeding, severe liver disease, severe immune system disorders, and bone marrow suppression.
Biologic DMARDs like abatacept, tocilizumab, infliximab, and rituximab can be added to the previously mentioned DMARDs if they fail to improve the patient’s condition.

It is recommended to take corticosteroids or antihistamines before administering them, as their administration can cause infusion site reactions like redness and pain.

Most biologic DMRADs should not be administered by patients suffering from heart failure.


Based on my research, I conclude that Cymbalta may provide some relief for polymyalgia rheumatism (PMR) pain in certain cases, especially when coexisting with fibromyalgia. However, it is essential to note that Cymbalta is not a recommended treatment specifically for PMR-related pain. 

I found that the primary medications indicated for PMR are corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and disease-modifying antirheumatic drugs (DMARDs)

If Cymbalta were utilized for PMR, I believe that it is vital to be aware of potential side effects, including nausea, dry mouth, headache, dizziness, fatigue, and insomnia.

Finally, in my perspective, you must consult with a doctor to determine a suitable treatment plan for polymyalgia rheumatism.

Was this helpful?

Thanks for your feedback!



Acharya S, Musa R. Polymyalgia Rheumatica. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


Dhaliwal JS, Spurling BC, Molla M. Duloxetine. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


Onuţu AH. Duloxetine, an antidepressant with analgesic properties – a preliminary analysis. Rom J Anaesth Intensive Care. 2015 Oct;22(2):123-128. PMID: 28913467; PMCID: PMC5505372.


Yokota Y, Namiki H. Pitfalls in diagnosing geriatric general pain: coexistence of polymyalgia rheumatism and fibromyalgia. BMJ Case Rep. 2019 Jul 23;12(7):e230078. doi: 10.1136/bcr-2019-230078. PMID: 31340948; PMCID: PMC6663217.


Karageorgiou I, Kokkinakis S, Maliotis N, Lionis C, Symvoulakis EK. Maximizing patient benefit through a reversed pathway from specialist to generalist: the case of chronic pain. Med Pharm Rep. 2021 Oct;94(4):512-515. doi: 10.15386/mpr-1873. Epub 2021 Oct 30. PMID: 36105499; PMCID: PMC9389878.

Find a supportive therapist who can help with Depression.

Discover the convenience of BetterHelp, an online therapy platform connecting you with licensed and accredited therapists specialized in addressing issues such as depression, anxiety, relationships, and more. Complete the assessment and find your ideal therapist within just 48 hours.


AskYourPharm is user-supported. We may earn a commission if you sign up for BetterHelp’s services after clicking through from this site