Houston Methodist. Leading Medicine

Neck FAQ

Question:

What's the difference between neck pain from a whiplash (car accident) and neck pain from fibromyalgia? I'm wondering if maybe I have both problems. It's too complicated to explain why I think this so maybe you can't answer the question without more details from me. But if you can tell me, it would be very helpful.

Answer:

Whiplash is defined as a sudden extension of the cervical spine (backward movement of the neck) and flexion (forward movement of the neck). This type of trauma is also referred to as a cervical acceleration-deceleration (CAD) injury. Rear-end or side-impact motor vehicle collisions are the number one cause of whiplash with injury to the muscles, ligaments, tendons, joints, and discs of the cervical spine. There is a problem called whiplash associated disorder (WAD). Patients with this problem experience neck pain, stiffness, and tenderness over the neck muscles. Sometimes there is a decrease in neck and/or shoulder motion. When these symptoms persist beyond the expected time for an acute injury, they become chronic. This time period is usually anything past three months. Whiplash associated disorder (WAD) doesn't usually cause widespread pain (throughout the body) like fibromyalgia does. Pain in fibromyalgia is present in soft tissues throughout the body. Pain and stiffness concentrate in spots such as the neck, chest, shoulders, elbows, knees, buttocks, and lower back. The tender spots don't seem to be inflamed. Most tests show nothing out of the ordinary in the anatomy of people with fibromyalgia. Tenderness or painful points of specific muscles in the upper neck point to WAD. A similar painful response of the lower neck and upper shoulder are more common in people with fibromyalgia, Obviously, the cause of whiplash associated disorder is the extension-flexion injury. The causes of fibromyalgia are unknown. Sometimes fibromyalgia occurs as a result of an injury like a whiplash or some other medical condition. So fibromyalgia can be primary (the main problem) or secondary (caused by other problems). James P. Robinson, et al. Determination of Fibromyalgia Syndrome After Whiplash Injuries: Methodologic Issues. In Pain. June 2011. Vol. 152. No. 6. Pp. 1311-1316.

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