FIBROMYALGIA SYNDROME & WHIPLASH TRAUMA
As noted above, a number of studies have linked Fibromyalgia Syndrome to physical trauma, including whiplash injury after a car accident.
In their 1992 book, Painful Cervical Trauma, Diagnosis and Rehabilitative Treatment of Neuromusculoskeletal Injuries, C. David Tollison and John Satterthwaite state:
“A particularly frustrating group of patients are those with a typical whiplash injury who, rather than gradually improving, actually seem to progressively develop a generalized chronic pain state identical to the fibromyalgia syndrome.”
Tollison and Satterthwaite state that fibromyalgia follows trauma approximately 22% of fibromyalgia patients.
In 1992, Greenfield and colleagues reviewed 127 cases of fibromyalgia and determined that 23% were triggered by a traumatic event. They also noted that patients suffering from trauma fibromyalgia were more disabled than those suffering from primary (non-traumatic) fibromyalgia.
In 1994, Waylonis and Perkins evaluated 176 patients who had been suffering from post-traumatic fibromyalgia. The traumatic cause was determined to be whiplash injury in 61% of the subjects. Years after the initial diagnosis, “eighty-five percent of the patients continued to have significant symptoms and clinical evidence of fibromyalgia.
In 1997, Buskila and colleagues studied the relationship between cervical spine injury and the development of fibromyalgia syndrome. They assessed 102 patients with neck injury and a control group of 59 patients with leg fracture. Twenty-two percent of the neck injury patients developed fibromyalgia, while only 1.7% of those with leg fracture developed fibromyalgia. The authors concluded “fibromyalgia syndrome was 15 times more frequent following neck injury than following lower extremity injury.”
In 2002, Al-Allaf and colleagues stated that 25% to 50% of those with Fibromyalgia Syndrome have physical trauma immediately prior the onset.
In 2003, Neumann and colleagues evaluated the outcomes of 78 post-traumatic neck injury fibromyalgia cases. They determined that 60% were still suffering from their fibromyalgia symptoms at the three-year follow-up. They also determined that nearly all of the persistently symptomatic patients were women, indicating that whiplash fibromyalgia recovery is worse in women than men.
In 2005, Samuel McLean and colleagues from the University of Michigan Medical Center established the criteria to assign fibromyalgia to whiplash trauma. They state:
“To summarize, there are abundant data suggesting that it is biologically plausible that physical trauma, acting as a stressor, could lead to the development of chronic widespread pain, as well as a number of other somatic symptoms.”
“Using these above attribution elements, the association between fibromyalgia and motor vehicle collision meets criteria one (temporal association), two (lack of alternative explanations), three (biological plausibility), six (analogy), and possibly five (re-challenge). This meets or exceeds the recommended threshold for suspecting a causal relationship between an exposure and subsequent illness. To put the relationship between fibromyalgia and trauma in context, there are at least as much data supporting this relationship as there are for many other accepted environmentally associated rheumatic diseases.”
“Thus, trauma may be only one of many types of stressors capable of producing symptoms characteristic of fibromyalgia.”
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Watching Your Back,
Dr. Michael Reiss