Posted by MERM on 6/21/2008, 11:26 am
1/Neck injury and fibromyalgia-- are they really associated?
OBJECTIVE: To investigate whether whiplash injury may be a trigger for the onset of fibromyalgia (FM).
METHODS: One hundred fifty-three patients presenting to the emergency room with the diagnosis of whiplash injury were examined. The control group included 53 patients hospitalized with fractures of the limbs, spine, and ribs due to road accident. The study and control groups were interviewed shortly after presenting and then followed prospectively. Patients complaining of musculoskeletal symptoms during followup were examined and a count of 18 tender points was conducted. FM was diagnosed if the patient fulfilled currently accepted 1990 American College of Rheumatology criteria.
RESULTS: The mean followup period for the study and control groups was 14.5 months (range 12-18) and 9 months (range 6-14), respectively. There were no differences between the groups with regard to age, sex, marital, education, or employment status.
During the followup period only one patient in the study group and no patients in the control group developed signs and symptoms of FM. Three patients in the study group (2%) and 15 patients in the control group (16%) filed insurance claims; none was associated with FM.
CONCLUSION: Whiplash injury and road accident trauma were not associated with an increased rate of FM after more than 14.5 months of follow up.Rheumatol. 2006 Jun;33(6):1183-5.
2/Outcome of posttraumatic fibromyalgiaOBJECTIVE: To assess the outcome of fibromyalgia syndrome (FMS) after cervical spine injury.
METHODS: Seventy-eight of 102 (77%) patients with neck injury were recruited 3 years after the original study in 1996. Twenty of the original 22 patients with FMS were available for reevaluation in 1999. 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 FMS-related symptoms. FMS was diagnosed by using the American College of Rheumatology 1990 criteria. Additional questions assessed measures of physical functioning and quality of life.
RESULTS: Sixty percent of the 20 patients who had FMS in 1996 still had it 3 years later. All the 11 women with FMS, but only 1 of the 9 men with FMS, met FMS criteria in 1999. Only 1 of 58 patients who had no FMS in 1996 developed FMS. The quality of life scores for most patients improved, their tenderness scores decreased, and all remained employed.
CONCLUSIONS: The outcome of posttraumatic FMS in patients with neck injury seems to be more favorable in men than in women; however, this finding should be interpreted with caution because of the small sample.
Patients who do not develop FMS within 1 year of neck injury have a low probability of developing FMS in the future, comparable to the incidence of FMS in the general population. Arthritis Rheum. 2003 Apr;32(5):320-5.
3/Musculoskeletal injury as a trigger for fibromyalgia
The issue of musculoskeletal injury as a trigger for fibromyalgia (FM) is controversial.
The present review critically evaluates the evidence that trauma can initiate FM, specifically addressing the scope of the problem, the issue of causality, possible pathophysiologic mechanisms, and medicolegal aspects.
One major problem is the fact that most of the data come from anecdotal reports and small case series and not from controlled prospective studies.
Overall data from the current literature are insufficient to indicate whether causal relationships exist between trauma and FM.
However, recent reports suggest that soft tissue trauma to the neck can result in an increased incidence of FM compared with other injuries.
Future studies should prospectively document the chronology of symptoms from the onset of trauma and repeatedly evaluate the patients for disability, quality of life, change in occupation, and litigation status.Curr Rheumatol Rep. 2000 Apr;2(2):104-8.wellnesstrain!M!
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