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Does trauma cause fibromyalgia? (Pro And Con).

Internal Medicine News

| November 15, 2002 | COPYRIGHT 2002 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

YES

Of the almost 1,000 fibromyalgia patients in my practice, I would estimate that half have fibromyalgia associated with trauma. Of those, three-quarters have had head or neck trauma.

A growing body of evidence, while not exactly proving that musculoskeletal injury can cause fibromyalgia, gives us that picture as well as some ideas of what mechanisms might result in fibromyalgia.

One of the most convincing studies to link fibromyalgia and trauma suggests that head and neck trauma are more strongly associated with fibromyalgia than are other types of trauma. The investigators in Israel assessed 102 patients with traumatic neck injury and 59 control patients with leg fractures. The patients were evaluated for tender points, interviewed about the presence and severity of neck or fibromyalgia-related symptoms, and diagnosed using the 1990 American College of Rheumatology criteria.

The neck-trauma patients were 13 times more likely to have fibromyalgia than were the controls (Arthritis Rheum. 40[3]:446-52, 1997). This would appear to make sense. Injuries dose to the head and central nervous system would be more likely to cause generalized symptoms or a generalized syndrome.

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