A New Look at Fibromyalgia...it's not always what we think!
While patients with fibromyalgia often report symptoms consistent with cervical myelopathy, a detailed neurological evaluation is not routine.
This study sought to determine if patients with fibromyalgia have objective neurological signs of cervical myelopathy.
Of the 270 patients, with the diagnosis of fibromyalgia (mean 8yrs of symptoms):
87% were women
95% had neck & back pain
95% had fatigue
83% had grip fatigue
80% had paraesthesia
71% had dizziness
…and 80% of patients reported worsening symptoms with neck extension.
The neurological exam was also consistent with cervical myelopathy as…
83% had affected upper thoracic spinothalamic sensory level
64% had hyperreflexia
28% had positive Romberg sign
25% had ankle clonus
26% had positive Hoffman sign
15% had dysmetria
…and 46% had significant spinal canal stenosis as demonstrated on MRI and CT imaging of the cervical spine.
What can we learn from this study?
These findings indicate that some patients who carry the diagnosis of fibromyalgia have both signs and symptoms consistent with cervical myelopathy, most likely resulting from spinal cord compression. They recommend detailed neurological evaluation of patients with fibromyalgia in order to exclude cervical myelopathy, a potentially treatable condition.
Posted on: September 10, 2005
Categories: Fascinating Pain Studies