Since there is no known cause of PMR and the primary treatment is a steroid that is also an anti-inflammatory it would be difficult to determine if any single inflammation in a body prior to starting a long-term steroid was a precursor to PMR. Don't get me wrong - we all want to know more about how we let PMR in, or should we have known, or better yet, should a doctor have seen it coming. I have come to the conclusion that we will never know because the medical profession has no clue either. I have had to learn to look forward rather than back while on my PMR journey. Hard lesson for me to learn but we have some degree of control when we look forward and no control when we look backwards at history. Learning from the past is most valuable if we can apply that knowledge to the future.