We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Patients With Fibromyalgia Must Be Treated Fairly

Thomas J. Romano, MD, PhD
Arch Intern Med. 1999;159(20):2481-2482. doi:.
Text Size: A A A
Published online


The recent article in the ARCHIVES by Goldenberg1 concerning fibromyalgia (FM) is an attempt to review the medical literature on this fascinating condition, but it has shortcomings, especially in the areas of causation and disability. This is a selective review omitting many important studies whose conclusions disagree with those of the author. For example, Goldenberg writes that "Evidence to determine whether there is a causal relationship between trauma and FM is currently inadequate." To support this statement, he cites 3 articles, 1 by Wolfe,2 another by Bennett,3 and a third by Buskila et al4 (Wolfe is a coauthor). Goldenberg neglects to mention that Buskila et al4 conclude their article with the statement that "Thus, trauma may cause FM, but it does not necessarily cause work disability." In addition to citing other reviews and opinion pieces in the medical literature, Goldenberg should have also referred to actual patient studies designed to determine if trauma was indeed a causal factor in the development of FM. Every study that has examined the relationship between trauma and fibromyalgia has revealed that trauma can indeed be a potential cause of this painful and frustrating problem.48 In fact, Bennett9 has described the most likely scenario of how a local muscle injury can progress to the development of FM and was one of the coauthors of an article in which he attests that in the medical/legal setting, where causation is "to a reasonable degree of medical probability," trauma is likely to be the cause of FM in some patients.10 Goldenberg advocates the abandonment of the term posttraumatic fibromyalgia. What is the justification? Even Wolfe11 has authored an article with posttraumatic fibromyalgia in the title! The term posttraumatic fibromyalgia further defines the syndrome and is useful in conveying information regarding causation.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles