Article Figures & Data
Figures
- Figure 1.
A directed acyclic graph modeling causal paths, emphasizing the trauma-post trauma pathway. FM: fibromyalgia; CWP: chronic widespread pain.
Tables
Study Type Author Outcome Quality5,16 Case report Wolfe, 199418 Describes FM development after trauma Very low Mailis, 200019 Describes FM development after trauma, in reality is malingering Very low Goldenberg, 201117 Describes FM development after trauma Very low Case series Greenfield, 199220 23% reported having antecedent trauma, surgery, or a medical illness Very low Cross-sectional surveys Bennett, 200721 Physical injury (not MVA) 17.1%, MVA 16.1%, surgery 16.1% Very low Waylonis, 199422 Of 176 patients with posttraumatic FM, 60.7% followed an MVA, 12.5% after a work injury, 7.1% after surgery, 5.4% after a sports-related injury, and 14.3% after various other traumatic events Very low Retrospective case-control Al-Allaf, 200223 39% FM patients reported significant physical trauma in the 6 months before the onset of their disease, compared with 24% of controls (p < 0.007) Very low Cohort Buskila, 199725 Compared FM neck injury vs leg fracture. FM found in 21.6% vs 1.7%, “13 times more frequent” Low Tishler, 200627, 201128,54 Compared FM following “whiplash” vs patients hospitalized for severe MVA trauma. 0.6% vs 0.0% developed FM in ∼1 yr. Similar results after 3 yrs followup Low Nested case-control Jones, 201130 Cohort of 2069 non-CWP individuals: (11.6%) developed CWP over 4 yrs. Moderate Covariate adjusted OR for widespread pain from any traumatic event 1.01 (0.73–1.40), MVA 1.50 (0.89–2.52), surgery 0.77 (0.50–1.18) Prospective cohort Wynne-Jones, 2006a5 Cohort of persons experiencing a MVA: the onset rate of CWP 6 mos later was low (8%), though in comparison with the non-MVA group there was an increased risk [RR = 1.9 (95% CI, 0.8 to 4.8, adjusted for age and sex)]; this was attenuated after adjustment for pre-MVA (prior) psychological distress and somatic symptoms [RR = 1.4 (95% CI, 0.5 to 3.2)]. A motor vehicle crash is unlikely to have a major effect on the new onset of widespread pain Moderate Wynne-Jones, 2006b31 In cohort of persons experiencing a MVA, predictors of CWP were post-MVA symptoms (RR 2.5, 95% CI 1.2–5.1), precollision health-seeking behavior (RR 3.6, 95% CI 1.6–7.9), precollision somatization (RR 1.7, 95% CI 0.99–2.8), perceived initial injury severity (RR 1.7, 95% CI 0.9–3.3), older age (RR 3.3, 95% CI 1.5–7.1). In combination, these factors accounted for about a 20-fold difference in the risk of new-onset widespread pain Moderate -
MVA: motor vehicle accident; FM: fibromyalgia; CWP: chronic widespread pain.
-
