@mlz
It can be impossible to distinguish between PMR pain and wear and tear arthritis pain, or pain from anything else but the PMR. I have arthritis of varying degrees in all my joints, but the most severe is in my cervical spine, along with spondylosis and stenosis. The pain from that can radiate to my shoulders, with a lesser chance that it could even affect my lumbar spine, hips and lower extremities. I also have SMM. My hematologist oncologist doesn't think the SMM is causing pain yet, but my rheumatologist isn't convinced that something else is not affecting my shoulders and causing pain. Try not to worry too much about what may happen. Stress, worry and anxiety can be the cause of many health issues if you allow it to become a factor. Trust in your doctors and good luck with your surgery!