Fibromyalgia syndrome (FMS) is a potentially disabling chronic pain condition, and is the most frequent cause of chronic widespread pain (Kransler et al., 2002). It is 13 times more common following cervical spine injury compared to its association with leg fractures, and there is an overall 22–24% prevalence following cervical spine injuries, amounting to approximately 1.5 million patients whose ﬁbromyalgia may be associated with cervical spine trauma (Buskila et al., 1997; Wolfe, 1990).
In our experience, patients with cervical traumaassociated ﬁbromyalgia describe full body pain and pain in the hands and feet and use descriptors such as ‘‘burning’’, ‘‘stabbing’’, ‘‘sharp’’, and ‘‘shooting’’, compared with terms such as ‘‘dull’’ and ‘‘diffuse aching’’ used by other ﬁbromyalgia patients. In general, there is a higher incidence and greater severity of headaches in this group and a characteristic affective quality to the pain that is reminiscent of central pain. Clinically, this is qualitatively different from the headache complaints and affective quality that accompany ﬁbromyalgia not associated with cervical trauma.
In our experience, patients with cervical trauma onset ﬁbromyalgia have hyperactive patellar re- ﬂexes and speciﬁc dermatomal hyperesthesia indicating a degree of spinal cord and nerve root irritation not seen in ﬁbromyalgia that is unrelated to cervical trauma. Despite these clinical observations, however, an unequivocal causal link between ﬁbromyalgia and cervical trauma has not been established