What is the first-line treatment for a patient presenting with acute symptoms of polymyalgia rheumatica?

The first-line treatment for a patient presenting with acute symptoms of polymyalgia rheumatica is low-dose prednisone. Polymyalgia rheumatica is characterized by muscle pain and stiffness, typically affecting the shoulders and hips, and is often associated with elevated inflammatory markers. Corticosteroids, particularly prednisone, are effective in quickly alleviating these symptoms due to their potent anti-inflammatory properties.

Starting treatment with a low dose of prednisone can lead to rapid improvement in symptoms, which is a hallmark of the condition. This approach not only helps manage pain and stiffness but also addresses the underlying inflammation that contributes to the patient's discomfort.

Other options, while they may be useful in managing associated conditions or symptoms, are not considered first-line for polymyalgia rheumatica. For example, aspirin and ibuprofen are nonsteroidal anti-inflammatory drugs (NSAIDs) that can help with pain relief but do not provide the same level of anti-inflammatory effect as corticosteroids. Physical therapy can be beneficial as part of a comprehensive management plan, but it is not indicated as an initial treatment for acute symptoms. Therefore, low-dose prednisone is the most appropriate first-line therapy to address the acute presentation effectively.