IS FIBROMYALGIA MORE LIKELY TO FOLLOW WHIPLASH INJURIES THAN LOWER LIMB FRACTURES?
Dan Buskila, Professor of Medicine from Soroka Medical Centre, Beer Sheva, Israel, reviewed his now famous (or infamous) paper suggesting that fibromyalgia is more likely to follow whiplash injuries than lower limb fractures. He was gracious enough to admit that there were many problems inherent in his study, beginning with the problems relating to the l990 criteria in terms of diagnosis, i.e., no gold standard, the criteria are circular, pain is a continuum and doesnt have a sudden start and stop, evaluating tender points is subjective both from the patient’s and physicians point of view, there is potential for abuse in terms of tender point criteria, etc, etc). He pointed out that Smythe in l989 originally speculated that trauma could precipitate fibromyalgia. Buskila then quoted Greenfield et al in Arthritis & Rheumatism l992 who suggested that 23% of patients with fibromyalgia had identified a specific precipitating event. In his own study (published in Arthritis & Rheumatism l997)
