8 Key Symptoms of Giant Cell Arteritis You Should Know

Giant cell arteritis (GCA), also known as temporal arteritis, is a serious inflammatory condition that affects the arteries, particularly those in the head, temples, and neck. This condition primarily affects adults over 50 years old and requires prompt medical attention to prevent serious complications, including permanent vision loss. Understanding the symptoms of giant cell arteritis is crucial for early detection and treatment.

The inflammation caused by arteritis can reduce blood flow to vital organs and tissues, leading to a variety of symptoms that can significantly impact quality of life. If you experience any combination of the symptoms described below, especially if you’re over 50, it’s essential to consult with a healthcare provider immediately.

1. Severe and Persistent Headaches

One of the most common and distinctive symptoms of giant cell arteritis is a new, severe headache that differs from any headache you’ve experienced before. This headache typically affects one or both sides of the head and is often described as throbbing or piercing in nature.

Key characteristics of GCA headaches include:

• Sudden onset: The headache often appears suddenly and intensifies rapidly over days or weeks
• Persistent pain: Unlike typical headaches, this pain doesn’t respond well to over-the-counter pain medications
• Location: The pain is frequently concentrated in the temporal region (temples) but can affect the entire head
• Intensity: Many patients describe it as one of the worst headaches they’ve ever experienced

The headache may be accompanied by tenderness when touching the scalp or temples, making it uncomfortable to brush your hair or rest your head on a pillow.

2. Temporal Artery Tenderness and Swelling

The temporal arteries, which run along the sides of your head near your temples, often become visibly swollen, tender, and prominent in people with temporal arteritis. You may notice these arteries appearing as raised, cord-like structures under the skin.

Notable features include:

• Visible prominence: The temporal arteries may bulge or become more visible than usual
• Tenderness to touch: The area over the temporal arteries is often extremely sensitive and painful when touched
• Reduced pulse: In some cases, you may notice a weak or absent pulse in the temporal artery
• Skin sensitivity: The scalp over the affected arteries may feel sore and sensitive

This symptom is particularly significant because the temporal arteries are directly affected by the inflammatory process characteristic of giant cell arteritis.

3. Jaw Claudication (Pain When Chewing)

Jaw claudication is a highly specific symptom of giant cell arteritis, occurring in approximately 40-50% of patients. This term refers to pain and fatigue in the jaw muscles that occurs during chewing or talking and typically improves with rest.

Characteristics of jaw claudication:

• Progressive pain: The discomfort begins or worsens as you continue to chew, especially when eating tough or chewy foods
• Muscle fatigue: Your jaw muscles may feel tired or weak during meals
• Relief with rest: The pain typically subsides when you stop chewing and rest your jaw
• Bilateral or unilateral: The pain can affect one or both sides of the jaw

This symptom occurs because the inflammation affects the arteries that supply blood to the jaw muscles, reducing oxygen delivery during the increased demand of chewing.

4. Vision Problems and Eye Symptoms

Vision disturbances are among the most serious symptoms of giant cell arteritis and require immediate medical attention. The inflammation can affect the arteries supplying blood to the eyes and optic nerves, potentially leading to permanent vision loss if left untreated.

Common vision-related symptoms include:

• Sudden vision loss: Temporary or permanent loss of vision in one or both eyes, which may occur suddenly
• Blurred or double vision: Difficulty focusing or seeing two images of a single object
• Transient visual disturbances: Brief episodes of vision loss or dimming that resolves quickly (amaurosis fugax)
• Blind spots: Areas in your visual field where you cannot see
• Drooping eyelid: Weakness of the eyelid muscles causing ptosis

Vision loss can be the first symptom in some patients, which is why any sudden change in vision, particularly in individuals over 50 with other symptoms of GCA, should be treated as a medical emergency.

5. Scalp Tenderness

Many people with giant cell arteritis experience unusual tenderness and sensitivity of the scalp. This symptom can be quite distressing and may interfere with daily activities such as combing hair, wearing hats, or resting your head on a pillow.

Scalp tenderness manifestations:

• Sensitivity to touch: The scalp feels painful when touched, brushed, or pressed
• Discomfort when lying down: Resting your head on a pillow may cause significant pain
• Hair care difficulties: Brushing or washing hair becomes uncomfortable or painful
• Localized pain: The tenderness is often most pronounced over the inflamed temporal arteries but can be widespread

This symptom results from inflammation of the arteries in the scalp and the surrounding tissues, making the skin hypersensitive to pressure and touch.

6. Systemic Symptoms: Fever, Fatigue, and General Malaise

Giant cell arteritis is a systemic inflammatory condition, meaning it affects the entire body. Many patients experience general symptoms that indicate widespread inflammation.

Common systemic symptoms include:

• Low-grade fever: A persistent mild fever, typically between 99-101°F (37.2-38.3°C)
• Profound fatigue: Overwhelming tiredness that doesn’t improve with rest
• General malaise: An overall feeling of being unwell or uncomfortable
• Loss of appetite: Reduced desire to eat, which may lead to weight loss
• Night sweats: Episodes of excessive sweating during sleep
• General weakness: Decreased energy and stamina for daily activities

These symptoms often develop gradually and may be initially dismissed as signs of a viral infection or normal aging. However, when combined with other symptoms of GCA, they warrant immediate medical evaluation.

7. Polymyalgia Rheumatica Symptoms

Approximately 40-60% of people with giant cell arteritis also have polymyalgia rheumatica (PMR), a related inflammatory condition. PMR can occur before, during, or after the onset of GCA symptoms.

Polymyalgia rheumatica symptoms include:

• Shoulder pain and stiffness: Aching and stiffness in both shoulders, often the first symptom
• Hip and thigh discomfort: Pain and stiffness in the hips, buttocks, and thighs
• Morning stiffness: Severe stiffness lasting more than 30-60 minutes after waking
• Limited range of motion: Difficulty with activities such as raising arms, getting out of chairs, or climbing stairs
• Neck pain: Aching and stiffness in the neck region

The muscle pain and stiffness associated with PMR typically affect both sides of the body symmetrically and can significantly impact mobility and quality of life.

8. Unexplained Weight Loss

Unintentional weight loss is a common but often overlooked symptom of giant cell arteritis. This occurs as a result of the systemic inflammation affecting the body’s metabolism and the reduced appetite that often accompanies the condition.

Weight loss characteristics:

• Gradual decrease: Weight loss typically occurs over weeks to months
• Significant amount: Many patients lose 10-20 pounds or more without trying
• Associated with decreased appetite: The weight loss often correlates with reduced food intake
• Metabolic changes: Chronic inflammation increases metabolic demands and can lead to muscle wasting

While weight loss alone is nonspecific, when combined with other symptoms such as headache, jaw pain, or vision changes in an older adult, it should raise suspicion for giant cell arteritis.

What Causes Giant Cell Arteritis?

The exact cause of giant cell arteritis remains unclear, but researchers have identified several factors that contribute to the development of this condition:

Immune System Dysfunction: GCA is an autoimmune condition where the body’s immune system mistakenly attacks the arterial walls, particularly the temporal arteries. This causes inflammation and swelling that can restrict blood flow.

Genetic Factors: There appears to be a genetic predisposition to developing giant cell arteritis. Certain genetic markers and family history increase the risk, suggesting hereditary components play a role in susceptibility.

Age: Giant cell arteritis almost exclusively affects adults over the age of 50, with the average age of onset being around 70 years. The risk increases significantly with advancing age.

Gender: Women are approximately two to three times more likely to develop GCA than men, indicating that hormonal factors may influence disease development.

Ethnicity: The condition is more common in people of Northern European and Scandinavian descent, suggesting ethnic and geographic factors influence disease occurrence.

Environmental Triggers: Some research suggests that infections or environmental factors may trigger the inflammatory response in genetically susceptible individuals, though specific triggers have not been definitively identified.

Association with Polymyalgia Rheumatica: The strong connection between GCA and PMR suggests they may share common underlying causes or pathological mechanisms.

Frequently Asked Questions

Can giant cell arteritis go away on its own?

No, giant cell arteritis does not resolve on its own and requires medical treatment. Without proper treatment, GCA can lead to serious complications including permanent vision loss, stroke, or aneurysm. If you suspect you have symptoms of GCA, seek immediate medical attention.

How quickly do giant cell arteritis symptoms develop?

Symptoms can develop gradually over several weeks or appear more suddenly. Some people experience mild symptoms that progressively worsen, while others may have a rapid onset of severe symptoms, particularly vision problems. The timeframe varies among individuals, but prompt evaluation is essential regardless of how quickly symptoms appear.

Is giant cell arteritis the same as temporal arteritis?

Yes, giant cell arteritis and temporal arteritis are different names for the same condition. The term “temporal arteritis” is used because the temporal arteries in the head are commonly affected, while “giant cell arteritis” refers to the type of inflammatory cells (giant cells) seen under microscopic examination of affected arteries.

What age group is most at risk for giant cell arteritis?

Giant cell arteritis almost exclusively affects adults over 50 years of age, with the highest incidence occurring in people in their 70s and 80s. The condition is extremely rare in people under 50. If you’re over 50 and experience new, severe headaches or other symptoms described above, consult your doctor immediately.

Can vision loss from giant cell arteritis be reversed?

Vision loss from giant cell arteritis is often permanent once it occurs, which is why early detection and treatment are critical. However, prompt treatment can prevent further vision loss and protect the unaffected eye. Any sudden vision changes should be treated as a medical emergency to maximize the chances of preserving vision.

Is there a blood test for giant cell arteritis?

While there’s no single definitive blood test for GCA, certain blood tests can support the diagnosis. Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels indicate inflammation and are commonly elevated in people with GCA. However, diagnosis typically requires a combination of clinical symptoms, blood tests, imaging studies, and sometimes a temporal artery biopsy.

Can stress trigger giant cell arteritis?

While stress hasn’t been definitively proven to cause giant cell arteritis, it may potentially influence immune system function. The exact triggers for GCA remain unclear, but the condition is primarily related to age, genetics, and immune system factors rather than lifestyle or stress alone.

How is giant cell arteritis different from a regular headache or migraine?

GCA headaches are typically new in onset, severe, persistent, and don’t respond well to typical headache treatments. They’re often accompanied by other symptoms like scalp tenderness, jaw pain when chewing, or vision problems. Migraines usually have a history of similar episodes, may have triggers, and often respond to migraine medications. If you’re over 50 and experience a new, unusual headache pattern, seek medical evaluation promptly.

References:

• Mayo Clinic – Giant Cell Arteritis
• Johns Hopkins Medicine – Giant Cell Arteritis
• National Institute of Neurological Disorders and Stroke – Giant Cell Arteritis
• American College of Rheumatology – Giant Cell Arteritis
• Cleveland Clinic – Giant Cell Arteritis