Cytokine changes with microcurrent treatment of fibromyalgia associated with cervical spine trauma

Introduction

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

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