Post-traumatic fibromyalgia (FM). A long-term follow-up

This report describes a follow-up study of 176 individuals seen

between 1980 and 1990, in whom a diagnosis of post-traumatic

fibromyalgia was made. Sixty-seven people completed a lengthy

questionnaire and underwent a confirmatory physical

examination using the American College of Rheumatology

Criteria to confirm or deny the presence of fibromyalgia at

the time of follow-up. A total of 60.7% noted the onset of

symptoms after a motor vehicle accident, 12.5% after a work

injury, 7.1% after surgery, 5.4% after a sports-related injury

and 14.3% after other various traumatic events. Fifty-six of

67 individuals had 11 or more tenderpoints (average, 13.5), 3

had 10 tenderpoints, and 7 had fewer than 10 or no

tenderpoints [and thus did not have definite fibromyalgia-

MCM]. Study subjects were asked to compare the use of the

following for the first 2 yr after onset as well as the year

preceding the current evaluation: biofeedback, medications,

physical therapy, manipulation, massage therapy and

tenderpoint injections. In addition, we asked detailed

questions regarding symptoms commonly seen in association with

fibromyalgia (fatigue, sleep disturbance, etc.).

Symptoms of traumatically induced fibromyalgia are quite

similar to spontaneous fibromyalgia. There was a dramatic

reduction in the use of all forms of physical treatments.

Fifty-four percent continued to use over-the-counter pain

medications, and 39% were on antidepressants. Eighty-five

percent of the patients continued to have significant symptoms

and clinical evidence of fibromyalgia.

Waylonis GW, Perkins RH

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