The relationship between vertebral dysfunction and clinical features of fibromyalgia syndrome

G. O. Littlejohn, G. Granges

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9 Citations (Scopus)


Sixty patients with fibromyalgia syndrome, 60 with regional pain syndrome and 60 pain-free subjects, of whom 30 were fit and 30 unfit, were studied. Eight symptoms and four clinical signs were evaluated in the 180 subjects and as well they were each examined for the presence and distribution of vertebral and sacroiliac dysfunctions. Dysfunctions, defined using operational criteria, were found most frequently at upper cervical, upper thoracic and sacroiliac levels in patients and controls. For these dysfunctions fibromyalgia significantly (p < 0.001) differed from regional pain patients, regional pain patients from controls and aerobically fit from unfit controls. Dysfunctions were more common on the right. The number of vertebral and sacroiliac dysfunctions significantly (p < 0.001) and accurately (> 76%) discriminated the clinical signs and symptoms of patients and controls. It is felt that dysfunctions represent areas of changed spinal biomechanics, which with general or regional pain amplification, result in heightened spinal reflex activity causing clinical features characteristic of this group of chronic musculoskeletal pain syndromes. Many of the peripheral clinical features of fibromyalgia and related syndromes appear to relate to this mechanism.

Original languageEnglish
Pages (from-to)97-105
Number of pages9
JournalJournal of Orthopaedic Rheumatology
Issue number2
Publication statusPublished - 1 Jan 1995
Externally publishedYes


  • Clinical features
  • Fibromyalgia
  • Vertebral dysfunction

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