Rates of Fibromyalgia Following Cervical Spine Injury

(From the September 2005 The “G”Note)

Rates of Fibromyalgia Following Cervical Spine Injury. Arthritis & Rheumatism March 1997; 40(3):446-452.

ABSTRACT: Objective: To study the relationship between cervical spine injury and the development of fibromyalgia syndrome (FMS). Methods: One hundred two patients with neck injury and 59 patients with leg fractures (control group) were assessed for nonarticular tenderness and the presence of FMS. A count of 18 tender points was conducted by thumb palpation, and tenderness thresholds were assessed by dolorimetry at 9 tender sites. All patients were interviewed about the presence and severity of neck and SMS-related symptoms. FMS was diagnosed using the American College of Rheumatology 1990 criteria. Additional questions assessed measures of physical functioning and quality of life (QOL). Results: Although no patient had a chronic pain syndrome prior to the trauma, FMS was diagnosed following injury in 21.6% of those with neck injury versus 1.7% of the control patients with lower extremity fractures (P = 0.001). Almost all symptoms were more common and severe in the group with neck injury. FMS was noted at the mean of 3.2 months (SD 1.1) after the trauma. Neck injury patients with FMS (n = 22) had more tenderness, had more severe and prevalent FMS-related symptoms, and reported lower QOL and more impaired physical functioning than did those without FMS (n = 80). In spite of the injury or the presence of FMS, all patients were employed at the time of examination. Twenty percent of patients with neck injury and 24% of patients with leg fracture filed an insurance claim. Claims were not associated with the presence of FMS, increased FMS symptoms, pain, or impaired functioning. Conclusion: FMS was 13 times more frequent following neck injury than following lower extremity injury. All patients continued to be employed, and insurance claims were not increased in patients with FMS.

COMMENTS: Most chiropractors have patients with fibromyalgia. This study found that 31.6% of the patients with cervical spine injury in this study develop fibromyalgia an average of 3.2 months post-trauma. The authors state that the relationship cervical spine injury and fibromyalgia is still in the speculative stage. They do make special mention that biomechanical disturbances may be involved in its pathogenesis.