December 2025
Can Trauma Precipitate Fibromyalgia?
Pacific Northwest MD Legal Consulting Medical Perspective
When a 39-year-old woman was hit by a drunk driver on the driver’s side of her vehicle, she didn’t think the injuries were serious. She was seat-belted, the airbags didn’t deploy, and X-rays in the ER were negative. She was discharged with a diagnosis of soft tissue strain.
But weeks later, her pain hadn’t resolved. It had spread from her neck and chest to her shoulder and upper back. Physical therapy worsened her symptoms. MRI imaging was unremarkable. A bone scan later showed mild increased uptake in the clavicle and upper chest, but still no structural damage.
Eventually, she was referred to a rheumatologist, who diagnosed fibromyalgia, a chronic pain condition that appeared to be precipitated by the collision.
Her symptoms now included widespread pain, fatigue, “fibro fog,” and significant functional decline. One year post-collision, she remained symptomatic and struggled with daily activities and work.
Medical Insight: When Trauma Triggers Fibromyalgia
Fibromyalgia is not a structural injury. It’s a disorder of central pain processing, involving:
Neurochemical imbalances (e.g., low serotonin, norepinephrine, dopamine)
Central sensitization — where normal sensations become painful (allodynia)
Disrupted pain inhibition — the nervous system amplifies pain signals instead of filtering them
Although its exact cause remains unclear, physical or emotional trauma can unmask or trigger fibromyalgia, especially in individuals with predisposing factors.
In this case, persistent pain following trauma, negative imaging, and evidence of localized inflammation (bone scan) aligned with early central sensitization, a known precursor to fibromyalgia.
Why This Matters in Personal Injury Cases
Fibromyalgia often presents without objective findings — but that does not mean the condition is unfounded. Understanding how trauma can initiate central pain syndromes is essential in evaluating:
Causation
Credibility of symptoms
Long-term prognosis and damages
The absence of MRI or CT abnormalities doesn’t negate real impairment, especially when the timeline aligns, and other causes have been excluded.
Medical-Legal Takeaway
In personal injury and disability cases, fibromyalgia can be both real and trauma-induced.
A clear understanding of central pain mechanisms, paired with a detailed clinical timeline, helps attorneys:
Recognize when fibromyalgia may be causally linked to an event
Support claims in the absence of structural damage
Articulate functional impairment in a language that holds up medically and legally
Need help reviewing a case involving fibromyalgia, chronic pain, or unclear imaging findings?
Let’s talk. Early physician input can make a critical difference.
Let Us Know How We Can Help You
Medical Summary Reports
Help with strategies to promote medical theories
Interpretation of meaning, or lack thereof, of medical reports & records
Reviews of IME Reports
Independent Record Reviews
Assessment of case validity regarding medical issues
Referral to appropriate expert medical witnesses
Medical Research
Facilitation of communication with clients, families, professionals and service & governmental agencies
Case Coordination
Facilitation of communication with treating doctors
Table-side deposition assistance or deposition question preparation
As you know, we have purposefully kept our fees exceptionally low allowing you the opportunity to have us review your cases early in your representation while controlling your expenses.
CONTACT US for information or fee schedule.
info@pnwmdlegal.com or 503-308-9186
