INCREASED RATES OF FIBROMYALGIA FOLLOWING CERVICAL-SPINE INJURY - A CONTROLLED-STUDY OF 161 CASES OF TRAUMATIC INJURY

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 (cont rol 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 sit es, All patients were interview ed about the presence and severity of neck and FMS-related symptoms, FMS was diagnosed using the American Co llege of Rheumatology 1990 criteria, Additional questions assessed mea sures of physical functioning and quality of life (QOL). Results. Alth ough no patient had a chronic pain syndrome prior to the trauma, FMS w as diagnosed following injury in 21.6% of those with neck injury versu s 1.7% of the control patients with lower extremity fractures (P = 0.0 01), Almost all symptoms were more common and severe in the group with neck injury, FMS was noted at a mean of 3.2 months (SD 1.1) after the trauma, Neck injury patients with FMS (n = 22) had more tenderness, h ad 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 w ith neck injury and 24% of patients with leg fractures filed an insura nce claim, Claims were not associated with the presence of FMS, increa sed FMS symptoms, pain, or impaired functioning. Conclusion. FMS was 1 3 times more frequent following neck injury than following lower extre mity injury, All patients continued to be employed, and insurance clai ms were not increased in patients with FMS.